Help! Few questions befor doctor! My diet, feel like relapsing :(

Hi, recently I've been trying to recover from anorexia and I aim for at least 2500 calories a day although I find it very hard to get to it without eating lots of carbs and sugar and processed foods. All of my snacks consists of a sweet rather than savory food items such as Lunabars, Clif bars, donuts, cookies, biscuits, yogurt. I have a lot of questions and I will be seeing a nutritionist soon this week but I would like to have some answers beforehand.

1.) Is it truly alright for me to eat this much carbs and junk? I realized that my diet is very narrow and kinda unbalanced. Does it matter, at this stage, what I eat or is it more important to get the right amount, not caring about where it comes from??

2.) Will eating more of carbs and sugar make me more fat than of I were to eat proteins and fats?

3.) And this is kinda if topic but I was just wondering, is it bad to be even a little underweight? I mean I look completely normal, like my belly is larger than before (A LOT larger!) and before my ED when I was at a normal weight I would look out of shape and chubby, although I ran cross country and ate a balanced meal. I'm scared that I'll look a lot worse than before I got my ED and look even fatter and unfit.?

4.) Do I really need to have 2500+ calories? I'm 5' 3'' and weigh currently 95 lbs. I don't look terribly skinny, and I actually look pretty normal. I've had tried a diet of around 1800-2000 calories and seemed to gain weight perfectly fine. Why is 2500+ the magic number for recovery?

5.) Will I look like a fatty or something because of all the sugar I eat? I read everywhere that glucose and sugar just gets stored as fat. I'm really scared and confused. I eat way too much, won't I get diabetes or something or like cause an even worse disease, worse than my current state?

6.) Can I exercise? Or is it absolutely no exercise?! I can't believe that to recover, you have to eat a minimum of 2500 AND with no exercise? Won't I just be even more out if shape looking and look like a flabby, chubby person? THANK YOU!! ?For anyone that replies! Any advice is appreciated right now, especially with all the questions, stress and confusion I have. I really need some answers, anything even a tip. All this pressure is making feel like relapsing which I am trying to prevent and conquer! Thank you!!

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I have an open sore on the bottom of my foot — do I need to see a doctor?

Posted June 19, 2013, 2:00 am

I have an open sore on the bottom of my foot. Can I just cover it with a Band-Aid until it heals, or do I need to see a doctor?

I am glad you asked this question, because in most circumstances, just covering it with a Band-Aid is a really bad idea.

I’m guessing that this “sore” is more than some redness of the skin. I assume it is a little hole or crater, and that the top skin of the sole of your foot is gone. If that’s the case, what you’ve got is called a foot ulcer. A foot ulcer crater is often surrounded by a border of thickened, callused skin. (I’ve put an illustration below.) Some craters are shallow. In severe ulcers, the red crater may be deep enough to expose tendons or bones. If you have a foot ulcer, you should see your doctor.

People with diabetes are more likely to get severe foot ulcers. That’s because diabetes can cause nerve damage in the feet, which makes them less sensitive to pain or discomfort. People with diabetes can injure their foot significantly and not know it because they experience no pain. As a result, the ulcer can slowly get worse.

People with diabetes are at special risk from having a foot ulcer. Because diabetics often have poor blood supply in their feet, their foot ulcers have more trouble healing. Healing requires a good blood supply to provide energy and a steady flow of immune system cells to do its work.

Foot ulcers are vulnerable to infection. An untreated infection can develop into:

An abscess, or pus-filled pocket;A spreading infection of the skin and underlying fat;A bone infection;Gangrene, an area of dead, darkened body tissue.

If you have good circulation, your doctor can treat your foot ulcer by trimming away diseased tissue and removing any nearby callused skin. The doctor will apply a dressing and may prescribe specialized footwear to relieve pressure on the affected area. If there is a possibility of infection, you may need to take antibiotics.

Foot ulcers that do not respond to more conservative therapy may require surgery. If you have poor circulation, you may need surgery to correct blood-flow problems in your leg arteries. And if the circulation is poor enough, there may be no way to cure a foot ulcer, and the recurrent infections that develop in that ulcer, except by amputating the foot.

So if you’ve had one foot ulcer, you should see your doctor about it. After the ulcer is cured, you should take steps to help prevent future ulcers:

Examine your feet every day to check for rubbed areas, cracks or calluses.Wash your feet every day using mild soap and warm water. Dry thoroughly. Apply moisturizing lotion to dry areas.Wear roomy, well-cushioned shoes and soft, absorbent socks. window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

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How will the doctor determine if my father’s forgetfulness is Alzheimer’s disease?

Posted June 14, 2013, 2:00 am

My father’s memory has worsened lately, and we suspect he may have Alzheimer’s disease. Can you tell us what is involved in making a diagnosis?

There is no single test for Alzheimer’s disease. Diagnosing it begins with identifying symptoms associated with Alzheimer’s and ruling out other possible causes of memory loss.

Your father should begin with his primary care physician. This doctor can combine his knowledge of your father and his medical history with results from a physical exam and blood tests. He may discover that your father’s symptoms are related to medications he’s taking or perhaps a medical condition.

There are many causes of forgetfulness, confusion and inattentiveness besides Alzheimer’s disease. Most of the patients I have seen who start to worry that they may be developing Alzheimer’s never actually develop the disease.

Your father should expect a lot of questions about his memory. And since answering questions about memory and thinking requires memory and thinking, the doctor might want a family member who knows your father well in the room. The questions the doctor is likely to ask include:

How long have you been having problems?Did the trouble come on gradually or suddenly?What sorts of things have become hard to remember?Are your difficulties preventing you from doing ordinary things like cooking or paying the bills?

Your father (or his spouse/caretaker) may need to track his symptoms for several months. This will show if his symptoms are improving, staying the same or getting worse.

The physician may refer your father to a neuropsychologist. Neuropsychologists typically use a battery of paper-and-pencil tests, or computer-administered tests, to evaluate cognitive function. The tests assess attention, memory, executive function, language, spatial ability and even mood.

A brain scan — usually either computed tomography (CT) or magnetic resonance imaging (MRI) — may also be done. These scans can help rule out other conditions that could contribute to memory loss. They also can show shrinkage of the brain in areas that tend to shrink with Alzheimer’s disease, but they cannot identify Alzheimer’s with certainty.

However, the ability of other types of brain scans to diagnose Alzheimer’s has improved greatly in recent years. Especially promising is a positron emission tomography (PET) scan that uses a chemical tracer known as PiB.

In Alzheimer’s disease, a substance called amyloid-beta slowly gets deposited in the brain. It is invisible on most types of brain scans. However, when PiB is injected into a person’s blood, it binds to amyloid deposits in the brain. When the PET scan is done, it can see all the places where there are amyloid deposits.

Tests of chemicals in the spinal fluid, the liquid that surrounds the brain and spinal cord, also show promise in diagnosing Alzheimer’s. Most of these new technologies are still used largely for research. I predict they are going to become important in regular clinical medicine very soon.

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my doctor said whatttt!!?

I went to visit my doctor today to ask him about weight loss. His answer was, "if you could split one meal into 2 you will lose weight very fast!" Really? So just two meals a day and I'm good? What about eating at least your Bmr?

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My doctor thinks I have hypothyroidism — how will he diagnose it?

Posted May 09, 2013, 2:00 am

My doctor thinks I may have hypothyroidism. How will he make the diagnosis?

Hypothyroidism is the medical term for an underactive thyroid. Some conditions are hard to diagnose, but fortunately hypothyroidism is not one of them.

Your thyroid is a small gland in your neck that makes the thyroid hormones, called T3 and T4. These hormones leave the gland and travel in the blood to every cell in your body. Thyroid hormones influence the rate at which every cell, tissue and organ in your body functions.

Hypothyroidism occurs when your thyroid gland doesn’t produce enough thyroid hormones. Your body slows down, creating symptoms such as fatigue, depression, weight gain, feeling cold for no good reason, constipation and dry skin.

Your thyroid gland is controlled by another gland: the pituitary gland, which is in the brain. It sends a chemical message to your thyroid, telling it how much hormone to make. The chemical message is called thyroid-stimulating hormone (TSH).

Your brain is constantly sensing whether there is an adequate level of thyroid hormones circulating in your blood. If not, the pituitary makes more TSH. Higher levels of TSH prompt the thyroid to produce more thyroid hormones. Low TSH levels signal the thyroid to slow down production.

To diagnose hypothyroidism, your doctor will perform a physical examination and some blood tests:

Physical exam. Your doctor will assess the size of your thyroid by feeling around your neck. He or she will check for physical signs of hypothyroidism, such as coarse hair or hair loss, dry or yellowish skin, and pale or puffy appearance. Your weight, cholesterol levels and blood pressure will also be checked.TSH test. This test is the best way to determine if you have thyroid disease. (I’ve put a table showing the normal, low and high values for the TSH and other thyroid blood tests below.) If your TSH level is high, you are hypothyroid. If TSH levels are below normal, you are hyperthyroid: Your thyroid gland is making too much thyroid hormone. (There are exceptions to this, but they are infrequent.)T4 and T3 tests. Once secreted by the thyroid, only a small amount of T4 is “free” and available for immediate use. In hypothyroidism, there’s not enough free T4 in the blood. There’s also not enough T3 in the blood.

Together, the TSH, free T4 and T3 tests can establish a diagnosis. They can also indicate how severe your problem is.

The ranges below apply to people who are not yet taking thyroid medications.

Within normal range of 0.45–4.12 mIU/LWithin normal range of 0.8–2.0 ng/dLCentral (also known as secondary) hypothyroidism, indicating a pituitary disorderCentral (also known as secondary) hyperthyroidism, indicating a rare pituitary abnormality producing TSHSubclinical (mild) hypothyroidismSubclinical (mild) hyperthyroidism*An abnormal TSH level can indicate a range of problems depending on whether the pituitary gland is functioning normally.**The normal ranges in the bloodstream vary from lab to lab.Sources: Third U.S. National Health and Nutrition Survey; Subclinical Thyroid Disease: Scientific Review and Guidelines for Diagnosis and Management, 2004 (Consensus Panel Recommendation).

Fortunately, treating hypothyroidism is easy. You take thyroid hormone in pill form, to replace the hormone your thyroid gland is not making enough of. The same thyroid blood tests used to diagnose hypothyroidism also are used to determine if you’re taking the right dose of thyroid medicines. These tests are repeated regularly, since a person’s dose can change over time.

Diagnosing hypothyroidism has become much simpler and more precise since I went to medical school.

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Low-Income Patients Often Have Trouble Reaching Doctor Via Email

Title: Low-Income Patients Often Have Trouble Reaching Doctor Via Email
Category: Health News
Created: 3/1/2013 2:36:00 PM
Last Editorial Review: 3/4/2013 12:00:00 AM

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Tattoos Can Pose Health Hazards, Doctor Warns

By Robert Preidt

HealthDay Reporter

FRIDAY, March 1 (HealthDay News) -- Tattoos have become increasingly popular in the United States in recent years, but along with that comes a rise in problems such as allergic reactions and infections, an expert says.

More than one-third of Americans aged 18 to 25 report getting a tattoo, according to the Pew Research Center. But if you're thinking about getting "inked," there are some things to consider before you head to the tattoo parlor.

"Since tattoos are not regulated in any way, there are many unknowns that could pose potential problems for consumers in terms of the inks and tools used," Dr. Michi Shinohara, a clinical assistant professor of dermatology at the University of Washington in Seattle, said in an American Academy of Dermatology news release.

"It is especially important for consumers to be aware of the potential risks, report any problem that develops to the tattoo artist and see a board-certified dermatologist for proper diagnosis and treatment," Shinohara added.

Tattooing inks have changed a great deal over the years and many modern tattoo inks contain organic azo dyes with plastic-based pigments that are also used industrially in printing, textiles and car paint. Many unknowns exist about how these new tattoo inks interact with the skin and within the body.

Allergic reaction to the tattoo pigments is one of the most common problems associated with tattooing. Infections also can pose a serious threat to health. Along with localized bacterial infections, there have been reports of people being infected with syphilis and hepatitis B and C due to non-sterile tattooing practices, Shinohara said.

Skin cancer is another potential risk associated with tattoos because they can make it hard to detect cancer-related changes in moles. If you get a tattoo, make sure it's not placed over an existing mole.

A tattoo can also cause a reaction that creates a bump that resembles a type of skin cancer called squamous cell carcinoma. Because it is hard to distinguish from skin cancer, the bump could lead to potentially unnecessary and expensive skin cancer treatment, including surgery, Shinohara said.

She offered the following advice for people who want to get a tattoo:

Go to a professional tattoo parlor and to a tattoo artist who is licensed according to state requirements. Insist on seeing tattoo equipment in sterile packaging.Tell the tattoo artist if you have a reaction. If a problem lasts more than one to two weeks, see a dermatologist.People with a chronic skin condition such as psoriasis, eczema or a tendency toward keloid scarring should check with a dermatologist before getting a tattoo.Do not get a tattoo over a mole. Doing so will make it more difficult to diagnose a problem if the mole changes in the future.

More information

The U.S. Food and Drug Administration has more about tattoos and permanent makeup.

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Multiple Sclerosis: Questions to Ask Your Doctor

SOURCES:

National Multiple Sclerosis Society.

National Institute of Neurological Disorders and Stroke.

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