Is your husband a watch person?

This is a very important question. I assume the answer is no since he doesn't sport a watch regularly. In a sense, if this is the case, you're sort of damned if you do and damned if you don't because a watch person is going to be far too particular about any attempt at a gift, and a non-watch person won't necessarily appreciate the expenditure on a decent mechanical watch.

The watch-nuts here are going to find this... [more]
posted to Ask Metafilter by drpynchon at 5:11 PM on July 14, 2008

I am by no means an expert on the subject but I vaguely recall that interpreting ethanol concentrations in post-mortem tissues may be tricky. I think it's complicated by the fact that after death, depending on how and how quickly a body is preserved, tissue (or more accurately microbes within tissues) may begin to produce ethanol and other metabolites. Again, just a hunch.
posted to Ask Metafilter by drpynchon at 2:26 PM on July 12, 2008 marked best answer

I actually like sciatica's advice. I'm not familiar with your particular CPAP device, or at least this "C-flex feature" enough to know how similar it is to BiPap, but in your case, Bipap may make some theoretical sense. You can imagine that perhaps while you involuntarily swallow or your esophagus is kept artificially open by a high baseline positive pressure (the CPAP), you may develop this sort of gas and abdominal distention. By lowering the CPAP level you resolve this, but perhaps... [more]
posted to Ask Metafilter by drpynchon at 2:32 PM on June 7, 2008

Does this mean that after surgery I'll be having back pain from now on as a trade off for no more extreme hip and leg pain?

Not exactly. It's more like you will definitely have at least temporary and possibly lasting back pain in exchange for no guarantee of relief of your hip or leg pain. Surgery is a bit of a gamble which may well help and does so in many cases, but it should be taken seriously, and maybe deferred at least until more... [more]
posted to Ask Metafilter by drpynchon at 10:09 PM on June 4, 2008

It's absolutely true that you can have TSH around 2 and be functionally hypothyroid.

This is highly, highly unlikely.

So-called subclinical hypothyroidism and the range of normal TSH has long been debated, but virtually every expert you might ever come across will tell you that the debate is generally over patients with TSH levels between 2ish and 5ish. Unicorn on the cobb's storry (with a TSH of 4.6) is a classic example. But... [more]
posted to Ask Metafilter by drpynchon at 12:18 AM on June 4, 2008

If anyone knows the answer to this, I would appreciate it: Is it possible to have a tumor/nodule/anything that grows toward the throat and NOT outward? It would make it hard to swallow but not be easily felt by the doctor (she checked me with her hands for lumps and bumps last week, but my throat problems have gotten significantly worse since then).

Yes. Definitely, yes. I've seen it first hand a number of times. In fact, since we're... [more]
posted to Ask Metafilter by drpynchon at 7:51 PM on June 4, 2008

drink lots of water. this will signal to the body that water is nt scarce and allow you to shed excess water stores.

drink at least a gallon a day

Are you being serious? This advice by the way is nonsensical to say the least and potentially dangerous. In simple terms, adding more water is not a good way to get rid of water.

There are over the counter diuretics out there but I certainly... [more]
posted to Ask Metafilter by drpynchon at 7:43 PM on May 31, 2008

This is all very premature, and with due respect, though I personally have some professional expertise on this subject, folks here simply can't give you the information you need yet. At this point this could be anything from a benign lesion with no impact on her life expectancy to something potentially quite serious. What I can tell you is that firstly, in general, I have seen plenty of patients her age who have both tolerated wedge resections of the lung as well as chemotherapy for a variety of... [more]
posted to Ask Metafilter by drpynchon at 10:17 PM on May 28, 2008

My usual advice in this sort of scenario echos what some others have said with respect to protein intake. There is a growing body of medical literature that supports my clinical experience, which is that increasing the fraction of protein relative to fat and carbohydrate in your diet will lead to earlier satiety. It may also help augment energy expenditures, and in combination with resistance exercises, will promote maintenance of muscle mass relative to fat in a net catabolic state.
posted to Ask Metafilter by drpynchon at 9:03 PM on May 27, 2008

I wouldn't recommend it. What he can potentially do if he has no other contraindication (like advanced kidney disease, ulcer disease or prior allergy) is add an NSAID like ibuprofen, indomethacin or naproxen. This class of drugs actually may have particular additive benefit when it comes to ureteral stones as they relax the smooth muscle around the ureters and may ease the passage of stones in addition to their usual analgesic properies.

I assume he has already sought... [more]
posted to Ask Metafilter by drpynchon at 9:10 PM on May 19, 2008 marked best answer

Sorry to be another negative nancy, but 50k a year really is unrealistic as at best you will have to work superhuman hours to make that kind of money, and you'll likely have to sacrifice time more appropriately spent on your own academic research for time on side jobs which may potentially be prohibited anyway. Having known far too many graduate students, I have yet to meet one making that kind of money outside of maybe the occasional online poker pro (and I would strongly recommend against that... [more]
posted to Ask Metafilter by drpynchon at 10:58 AM on May 19, 2008

I think it's worthwhile to point out that as far as I know, there has never been a single study demonstrating increased risk of gastric cancer in humans chronically on proton pump inhibitor therapy. These have been the market for almost 20 years now, with perhaps millions of people or more on treatment. So please take rat studies with a grain of salt. The specific study in this case had an n of only 79 and an astounding 27% had cancer in the control group! That alone makes any... [more]
posted to Ask Metafilter by drpynchon at 3:32 PM on May 16, 2008

The "pre-cleansing" if you will, is by far the most unpleasant part -- stay close to a restroom is all I can say. The procedure itself, assuming the person sedating you knows what they're doing, you will hardly feel and you will even less remember.
posted to Ask Metafilter by drpynchon at 3:20 PM on May 14, 2008

You definitely, definitely need to see a gastroenterologist.

Few primary physicians do very well with the workup of what is now chronic diarrhea. My suspicion is that if the only thing wrong with your liver tests was a GGT of 300, and all the other enzymes, clotting tests and protein levels were normal, the liver may be a bit of a red herring and freaking out about the GGT is probably premature though it might warrant regular monitoring. That could be from alcohol,... [more]
posted to Ask Metafilter by drpynchon at 1:49 PM on May 14, 2008 marked best answer

You're asking the wrong question. The real questions are is your serum protein really high, and if so, why. I think total protein levels that high would be exceedingly unusual (it's unusual to begin with), especially in someone your age. I suggest maybe seeing a doctor and getting retested as this may have been a lab error.
posted to Ask Metafilter by drpynchon at 9:54 PM on May 6, 2008

I agree with ikkyu2. It's really a third party (the hospital/facility and its Radiology department) in most cases like this that have the material you need to request (CT scans on a CD and radiologists' reports). Pulmy1 probably documented a note with his initial opinions on your case and may have records of pulmonary function tests or blood work. These pieces of information would probably be obtained from Pulmy1's office but you don't necessarily have to deal with Pulmy1 directly. Just call... [more]
posted to Ask Metafilter by drpynchon at 5:59 PM on May 3, 2008

What iminurmefi said, essentially every single word, is spot on.
posted to Ask Metafilter by drpynchon at 8:25 PM on May 1, 2008

Start with Ubuntu. Period. There will be naysayers of course, and there are a few other distros that are perhaps similarly geared towards a relative beginner but none offer the network of support that exists for Ubuntu. Just go to ubuntuforums to see what I mean.

If you have windows installed right now, you can use Wubi to test out Ubuntu without making any real commitments in terms of repartitioning and such. It's a one-click uninstall in Windows, AND you can fiddle... [more]
posted to Ask Metafilter by drpynchon at 8:22 PM on May 1, 2008

I know it's easy to say but try not to panic. It sounds like your mom has clearly had a pretty rocky time these last few months, and I sense your yearning for things to get back to the way they were before -- who wouldn't want that. But the simple fact is that it sounds like she really hasn't bounced back yet. It only takes one bad infection to set off a domino effect of recurrent illness and complications in someone who was apparently fine a few months ago, and diabetics unfortunately are... [more]
posted to Ask Metafilter by drpynchon at 7:12 PM on April 10, 2008

I wanted to thank everyone for their answers, all of which have been very helpful. Again, the description was second hand so apologies on the lack of clarity. The best I can get (and again, I'm not even exactly sure what it means for an engine to turnover as I'm a car moron too) is that when she turns her key she gets more than the slight clicking sound of the starter itself, but also the cranking sounds of the engine but it won't complete umm.. start and then the high pitched belt-like noises... [more]
posted to Ask Metafilter by drpynchon at 10:10 PM on March 31, 2008

jon1270, it sounds like it's getting right to RuvRuv followed by SqueakSqueakSqueak and no Vroom.
posted to Ask Metafilter by drpynchon at 6:19 PM on April 2, 2008

No worries jon, I appreciate your and everybody elses help with this.
posted to Ask Metafilter by drpynchon at 7:15 AM on April 4, 2008

Put it this way: if my doctor recommended this I'd find another doctor.
posted to Ask Metafilter by drpynchon at 8:45 PM on April 3, 2008

subbes, I believe ikkyu2 is suggesting rightfully, that using a stimulant with the possible side effects of causing systemic and pulmonary hypertension, increased heart rate, and valvular heart problems in order to treat a condition associated with cardiovascular mortality and morbidity probably rubs doctors the wrong way. While weight loss has been demonstrated to reduce the risk of various maladies, there's no reason to assume that it's irrelevant how you lose weight. Moreover, phentermine is... [more]
posted to Ask Metafilter by drpynchon at 7:01 PM on April 2, 2008

Off the top of my head, possibilities include diabetes, pancreatic insulinoma, intestinal parasites, tumors or trauma to the brain, thyroid disease, drugs, mood disorder, or just plain getting old. I'm sure there's lots more that aren't coming to mind. Outside of the drugs which people probably aren't slipping you without your knowledge, and the getting old which sadly I'm sure you are, you can read up on the rest but the best way to get reliable peace of mind is probably to see a doctor about... [more]
posted to Ask Metafilter by drpynchon at 6:51 PM on March 30, 2008 marked best answer

Do not -- I repeat -- do not pay any attention to any grand claims made about quantum phenomena made by anyone who is not a physicist. Consciousness and the mind (if you believe that these are rooted in interactions between networks of cells in your skull) function on a scale much larger and slower than the "quantum world" and as others have noted, it's not the conscious observer that affects the result in quantum experiments. It's the observation -- in other words, by whatever means... [more]
posted to Ask Metafilter by drpynchon at 8:40 AM on March 29, 2008

Yeah that terrible What the Bleep thing is to be avoided unless you're looking for a prime example of bad wooey borrowing from QM. It's not entirely crap -- there are some kernels of corn too in there, but...
posted to Ask Metafilter by drpynchon at 11:45 AM on March 29, 2008

I dont believe there is an answer to the question you are asking, and here is why.

Respectfully, this reasoning falls in line with the notion that we can't answer any questions because we don't "know" anything, as well as the logical fallacy inherent in proving a negative. Though in a sense tautologically true, it's also completely useless and moot.

To date, there has never, ever been a well designed, reproducible... [more]
posted to Ask Metafilter by drpynchon at 12:53 PM on March 29, 2008

Several points to consider, Nattie:

It's true that if you look at our world under a quantum lens, you might conceive of a universe of interacting, subatomic wavefunction probabilities. But think about the scales of things and the statistics you're dealing with when you even consider things like telepathy or telekinesis. Let's wave our hands and accept the (likely false) presumption that the mind and consciousness are the cause rather than the effect of things going on at... [more]
posted to Ask Metafilter by drpynchon at 11:07 AM on March 30, 2008

The answer to your question is no, it wouldn't all but guaranteer your son develops asthma. Nothing would all but guarantee he develops asthma because it's just not that ubiquitous. I'm sure you can go door to door in the new neighborhood and find countless kids who don't have asthma.

At this time, the link between environmental pollutants and asthma is not well established. It's been studied a fair bit, and the current epidemiological thinking is that certain particular... [more]
posted to Ask Metafilter by drpynchon at 8:52 AM on March 30, 2008

Go see a doctor. Despite the chorus above, even though this may be a sinus headache, sinus headaches are extremely overdiagnosed and a relatively uncommon cause of this sort of thing. Some of what you describe is not so consistent with sinus headache, including where you're feeling the pain. To me, what you describe is definitely concerning enough to get checked out by a doctor, and if you notice anything else concerning (especially say, abnormalities in your vision or nausea)... [more]
posted to Ask Metafilter by drpynchon at 2:32 PM on March 26, 2008

As others have suggested, the growing body of scientific literature on Mirena is turning the tide regarding its use in nulliparous women. A few practitioners just don't want to deal with the issue and get up to date. Other practitioners do recommend testing for STDs prior to its placement which is probably reasonable regardless, and more and more women are opting for it. It's true that without having prior births, placement of the IUD can be more uncomfortable and a fraction of nulliparous women... [more]
posted to Ask Metafilter by drpynchon at 9:28 AM on March 23, 2008

In fairness, to complete what I was saying before, the down-sides to the Mirena are for the most part up front -- pain with insertion, and the very small but real risk of a procedural complication. If it's successfully placed, a recent study demonstrated that expulsion rates were low and unaffected by parity, and the 1-year continuation rate was also similar in women with and without prior births (and better than combined oral contraceptives).

If you're interested in... [more]
posted to Ask Metafilter by drpynchon at 9:41 AM on March 23, 2008

Ok, firstly, it's not illegal to unlock/jailbreak your iPhone. That said, it will void your warranty. Secondly, there are big developments for the iPhone along the way but chances are none of them will hit the end-user until June or later. Among these, the two most important is that the next iteration of the iPhone is slated to be released with 3G within the next year (read the news about the 700 spectrum auction that AT&T just hunkered down billions for), and perhaps more importantly the... [more]
posted to Ask Metafilter by drpynchon at 10:40 AM on March 22, 2008

Yes you drink plenty, and enough to have severe, potentially dangerous withdrawal.

No, this shouldn't stop you from quitting, but since benzos are a mainstay of managing withdrawal symptoms I think given your prior dependence, it'll be tricky managing withdrawal medically though I'm by no means an expert on outpatient detox techniques. Professionals that do this more frequently than I probably have ways of addressing benzo dependence and alcohol withdrawal in the... [more]
posted to Ask Metafilter by drpynchon at 6:07 PM on March 20, 2008

uh, if you're really concerned why not suggest your SO get the vaccine?

The current available vaccines don't cover genotype 51.

HPV doesn't "clear up" is it a virus that may stay dormant for long periods of time, but always resurfaces at some point.

This is not true. 90% of most strains are cleared within 2 years of contraction. Also, anon, you should know that based on what... [more]
posted to Ask Metafilter by drpynchon at 2:05 PM on March 16, 2008

OP: In my opinion, the answers to your questions are yes and yes -- though I'm sure there's weird qualifying complexities to this as there is to any immune response (things like waning immunity). But think about it: we have vaccines for multiple strains that essential induce an immune response that's no different than clearing the virus on actually exposure and these vaccines are quite effective.
posted to Ask Metafilter by drpynchon at 10:13 PM on March 16, 2008

In strict medical terms (though even doctors screw this up all the time), there's a difference between "dehydration" and "hypovolemia;" the former is a loss of free water from total body water stores were as the latter is a loss of fluid volume (usually water and electrolytes) from extracellular fluid. Sometimes you can be both, but it's actually hypovolemia, particularly your circulating blood volume, that might cause your heart rate to go up.... [more]
posted to Ask Metafilter by drpynchon at 10:12 AM on March 15, 2008

Oh boy this is a toughy.

As a bit of preface, let me first say that I definitely ain't your or her doctor. However I am a doctor who does have a fair bit of experience with Cellcept, used primarily in the setting of solid organ transplantation. I have surprisingly not yet run into the issue of IUDs and Cellcept specifically. Also, in general, I'm a big fan of IUDs, know the general data fairly well, and in an otherwise healthy, never-pregnant woman would have no trouble... [more]
posted to Ask Metafilter by drpynchon at 8:23 PM on March 14, 2008

Thanks for that phearlez. I wasn't aware of it, but I do know that there are currently ongoing trials in the US trying to address the same question. That said, from an immunological standpoint, HIV differs a fair bit from Cellcept and Prednisone, so I wouldn't necessarily extrapolate much from HIV data.
posted to Ask Metafilter by drpynchon at 9:42 AM on March 15, 2008

1) Definitely, definitely look into emergency Medicaid as others have noted.

2) While I agree that it's somewhat odd and inappropriate for a patient to be hospitalized for 48 hours without seeing a doctor, I wouldn't be surprised if that wasn't the case though for some reason the family got that impression (which in and of itself is suboptimal communication at the least). You'd have to at least look at the medical records to know that, and I'd need a whole lot of... [more]
posted to Ask Metafilter by drpynchon at 4:08 PM on March 11, 2008

There are two common strains of herpes virus, so you may or may not have her strain already. It's more likely that you actually have a different strain as the strains have a relative predilection for oral or genital infection (though there is crossover). That said, you may even already carry both strains. There are many completely asymptomatic carriers of HSV-1 and HSV-2. The only way to limit transmission is via barrier methods, and even with perfect condom use, and in the absence of a... [more]
posted to Ask Metafilter by drpynchon at 7:23 PM on March 8, 2008

In this case, testing for antibodies may be the relevant issue as it likely reflects continued immune protection from reinfection. If the antibodies are positive you haven't simply been exposed to the virus; you've contracted it (as reflected by the immune response your body has developed) -- though this won't reflect whether you are symptomatic or not.
posted to Ask Metafilter by drpynchon at 7:50 PM on March 8, 2008

I agree with others. Trying to replace your motherboard/CPU in this case is going to lead to more trouble than its worth and may not solve your problem -- which is most likely to be your software. 4 yrs of Windows is enough to rack up viruses, useless memory hogs, hard drive frag, and perhaps worst of all, registry slog to really make a system unusable. And as you've probably figured out, the clean sweep approach to this is much more effective than trying to manually fix things or use a registry... [more]
posted to Ask Metafilter by drpynchon at 1:35 PM on March 2, 2008

My vote is unlikely but plausible perhaps. I'm not a 100% sure. When you donate blood you're losing about 10% (generally less) of your blood volume, which means you're also losing about 10% of the red blood cells that would probably be turning over soon. If this translated to 10% less stercobilin I'd say that shouldn't cause a major change in color. However, there is the possibility that a larger fraction of the products of bile are then reabsorbed in the distal small bowel as a possible... [more]
posted to Ask Metafilter by drpynchon at 11:48 AM on March 1, 2008 marked best answer

fshgirl: It's absolutely true.

And thinkingwoman: Don't blame men. The very early iterations of oral contraception had no placebo week. Greg Pincus pushed for it for a number of reasons, none of which had to do with his gender-limited knowledge of the ovarian cycle. There are polls and data to confirm that early on, before OCPs had gained acceptance, a lot of women really were uncomfortable with the idea of not having a period and feared the possibility of undetected... [more]
posted to Ask Metafilter by drpynchon at 7:16 PM on February 27, 2008

Clearly, as an former OB/GYN nurse, you need to do more reading yourself. Please to cite the studies that show increased cancer risk with Mirena. I'm happy to cite those that don't -- the consensus is that levonorgestrel intrauterine systems are protective against endometrial cancer if anything. What you say is patently wrong -- embarrassingly so for a nurse. Not one thing you said is remotely true. Not even remotely so in your inept appeal to authority.
posted to Ask Metafilter by drpynchon at 10:56 PM on February 27, 2008

tuff, since you brought up bone density this might interest you.
posted to Ask Metafilter by drpynchon at 5:08 PM on February 28, 2008

I agree with the folks above. At least if you're in the US, most GP's don't really serve as a barrier or gatekeeper for mental health care. In fact, generally the minute this sort of thing comes up in a primary care visit, after the history is taken, asking the patient if he or she is interested in counseling or psychiatric referral should pretty much be automatic. It's not stigmatized at all in practice and even the most inexperienced doctor runs into this several times a week if not daily. All... [more]
posted to Ask Metafilter by drpynchon at 2:20 PM on February 26, 2008

Here's another paper with some more data that might be of interest to you. They quote the median and mean retention time as 19.4 (11.4–27.5) & 18.3 (12.9–23.7) months with 95% confidence intervals as noted. 62% of people were still infected at 1 year with a 95% confidence interval of 46–78%. I didn't read the paper thoroughly enough to tell how reliable those numbers may or may not be though.
posted to Ask Metafilter by drpynchon at 7:19 PM on February 25, 2008