Comments by "Just Another Bucky Lover" (@JustAnotherBuckyLover) on "Institute of Human Anatomy"
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To clarify, The ketosis necessary to manage (usually) severe childhood epilepsy that is refractory to medication is very different from your regular keto diet. It MUST be carried out very strictly under medical monitoring because the risk is high and just one slip, one sandwich, one candy bar, one regular soda instead of a sugar-free one, will result in those uncontrollable seizures returning very suddenly. That's if the diet works at all (though, technically there are two). It's only about a 50:50 chance and there's no way to predict who will or won't respond well. Because they both are virtually carbohydrate-free, however, and may or may not also limit protein, they can also cause problems with cholesterol level, kidney issues, GI upsets, not to mention poor nutrition and growth. It's incredibly limiting, and this is why it's usually reserved for only those with the most uncontrollable seizures.
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Oh but don't you know? They're just for people who are too lazy to hold it in, like "adult diapers"... /s 🙄
There ARE some people with very light flow and who have particularly good pelvic floor muscles, I guess, and who have particular anatomy that allows the blood to pool in their vagina until they "let it out" or it overflows, but eh, they're very much the minority. The tiny minority. Those are the same people insisting the cervix has a sphincter though, oftentimes, and that anyone can do it. Utter rubbish. And in fact, this can be a particularly frustrating aspect for uterus owners who have had surgery to remove their rectum. Because the tissues that support the vaginal canal from behind are no longer there, the back wall can pooch backwards, allowing both normal secretions and menstrual fluid to gather before something happens to cause it to all rush out at once.
To me, this idea goes along with the people who have convinced themselves that periods are a symptom of a "toxic" lifestyle and it's actually not normal to have regular periods - but I feel like that's just a justification for the fact that these people are usually eating wacky diets and are probably suffering amenorrhoea because of their disordered eating habits.
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Abscesses are not fun. I have a condition called hidradenitis suppurativa (HS for short) and I always have at least a handful of them forming along with open wounds that are draining. Unlike regular abscesses though, the lumps from HS don't heal well - they often recur over and over again, they are slow to heal, they commonly cause sinus tracts and can discharge pus from multiple openings at once, cause massive ropes of scar tissue, and the worst part is they form in the most tender places - under the armpits, in the groin and perineal areas, crease of the backside, top of the thighs, chest/under breasts, behind your ears like this guy's was, along the hairline, on the jaw and even the face sometimes, on the stomach...
I right now have I think 5, maybe 6 ongoing - and that is pretty much as good as I get. It's no fun at all, and it's so commonly undiagnosed or misdiagnosed. Unfortunately, even if you try to drain them like this, or even excise them completely, they tend to just recur along the edges of the wounds, which may take months to heal up and need full-thickness skin grafts to cover the area, leading to reduced movement from the scarring etc. There's no definitive medical treatment; some antibiotics help for some people - mostly because of secondary effects more than their antibiotic properties - but often the only drugs that make an impact are heavy-duty immune-suppressing/modulating drugs.
I'm sorry your dad was sick enough to be hospitalised, it sounds like the infection was very bad, and I know how hard it can be to see your parent in a hospital bed. I was just a little younger than you when my dad had a stroke (he didn't make it sadly, but this was many years ago) and I couldn't bear to see him like that. I'm glad your dad recovered though, and hopefully, they got the infection controlled, along with his pain, and he was home and healing fast.
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1) anyone can experience that yes. Usually it doesn't cause full-on retention, but it can happen, especially if he had prostate issues prior to that, then this might have pushed him from being in chronic retention to acute complete retention.
2) Why would they assume she's lazy rather than actually take her to the doctor to have tests done? Of course there's a potential for physical issues, an otherwise healthy seven year old usually wouldn't be wetting themselves regularly. Occasionally, sure. Kids get easily distracted sometimes. It's no big deal, but if she's doing it regularly, then that's a whole different issue. Here are a bunch of things that you (and that child's parents) should be asking:
Is she getting distracted and not realising until it's too late and she's already peeing? Could be ADHD.
Does she not feel the urge to go until it's unbearable? Urgency is a thing with many causes;
Does she have an infection that could be causing urgency and frequency that is often uncontrollable even for adults?
Does she have some physical abnormality of the urinary tract that causes leaking regardless of her attempts at bladder control?
Is she even aware that she's leaking/peeing?
Does she have any recognition of having a full bladder? Does she ever show signs of deliberately holding (grabbing herself, squirming, potty dance, etc)?
Does it happen only during the day or at night too?
Has she ever been reliably dry, and if so, when did it change? If not, then why hasn't she been assessed thoroughly?
Does she ever NOT do it? Is it every time her bladder is full or just occasionally? Is she drinking enough? Cutting down fluids is the worst thing you can do because concentrated urine is irritating and will cause more urgency and frequency.
Is she holding because she has some kind of fear or issue with the toilet?
Does she have pain when she goes so she avoids it?
Has she been checked for either a UTI or some other infection (like a yeast infection or irritation from some kind of washing/laundry product)?
Is she also having bowel issues? Chronic constipation often goes without notice in kids, especially slightly older ones, and even by medical doctors, and faecal loading/impaction can cause concurrent problems with bladder continence too.
Does she have other issues like an intellectual disability or autism? While autism doesn't cause mental disability, it can screw around with interoception, anxiety, food issues can lead to severe constipation and faecal loading etc as well as sensory overload making it hard to process the signals from your own body in all of the noise.
These are just for starters. Depending on the answer, it depends on the response. I can pretty much guarantee that she's not just "being lazy" though. That is almost never the case and if it IS by choice, then she needs psychological therapy to find out why because sometimes things like abuse (including CSA) can cause wetting/bedwetting.
3) No, not really. It can slow your movements, and mobility issues can cause continence issues, and if someone has a prostate, that can potentially cause issues that might cause retention, and that can end up potentially leading to issues. I suppose as you age, your risk of bladder cancer also increases, so there's that too, but no, your bladder doesn't weaken as you get older making it more likely to burst.
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@mental_hazard if you can afford to deliberately ignore transphobia around you, as a trans person, then you are privileged, even in comparison to other trans people. When was the last time your family threatened to disown you? When was the last time you were threatened with physical harm or death? If the answer is "never" then MARVELLOUS I am super glad for you. But the fact remains that still gives you privilege, and if you can't appreciate that, it makes everything else moot.
Saying you have privilege isn't an attack. It's about appreciating that other people don't always have the same experiences as you, and may experience things far harder.
Telling anyone who is a victim of bigotry to "live with it" is not the answer. Ignoring it doesn't help, in fact, it gives them implicit licence to continue. If you personally need to avoid it for your own mental health, you do you, but don't tell other people they have to basically suck it up. And I stand by my point, that if you are only telling other trans people what to do, and not the legit transphobes just a few comments down, then that's a problem for me and it won't fix everything. Working to make the world better IS. You don't want to or can't? Scroll on by. Attacking other trans people and/or their allies for actually being proactive is not helpful.
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So why does a UTI or IC or other forms of bladder inflammation cause the need to pee more often and more urgently, even when the bladder is pretty much empty? It can't be from the stretching - does the inflammation irritate those stretch receptors somehow? It makes sense that the bladder and/or urethra would feel stinging/burning, or that there might be pelvic pain that radiates into the back etc. Because from my experience, the sensation of having to pee from a UTI or IC is very different from the feeling of actually having a full bladder... and ironically, the former is far harder to control than the latter too. The bladder spasms can be so powerful that I've been stuck in the bathroom for hours at a time because even a few drops is enough to cause my bladder to spasm.
If I had to guess, I'd say either the sensation of irritation etc is confusing the brain, or that there's physically some irritation of the detrusor muscle which causes it to contract more easily and/or more forcefully (or both). It'd make sense considering one of the many medications I was given was Detrusitol (which works to counter bladder spasms).
I can see an evolutionary benefit for it, I suppose - if you're peeing more often, hopefully you're getting rid of whatever is causing the irritation more often, making it harder for infecting organisms to hang around in there... but goddammit, IC is miserable.
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@williamscoggin1509 You would have heard it a lot if you were a woman having bad period pain. It's a common retort of doctors that "having a baby will solve your period pain". For some people, it does seem to help. Unfortunately, for many with extreme period pain (i.e. that which doesn't resolve with things like heat and over the counter medication like ibuprofen, and which causes you to routinely miss work, school, faint or throw up, etc) that's not true, especially if they have some underlying disease rather than just extra-strong uterine cramps, such as endometriosis, etc. It's thought that perhaps that the cervix maybe opens easier to allow the menstrual fluid to leave after delivery, or perhaps it's a shift in the hormones post-partum. It's great when that happens for women like Elizabeth. I just wish doctors wouldn't fob off women without even trying to help them for years... on average, the best part of a decade for people with endometriosis, and it's not even rare - it affects 1/10 women and girls.
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@NYCgirl927 That's precisely the point - that they forgot and by the time they remembered, she was in acute retention and her bladder contained around 2 litres of urine.
I mean, EDS Isn't super, super rare. It's very much underdiagnosed though, especially hEDS (it has a prevalence of up to 1/5,000). The trouble is that my friend (like many other Zebras), for example, wasn't diagnosed with hEDS until LONG after delivering three children when one kid also started showing obvious signs, and another had more subtle signs. They're STILL fighting to get an official diagnosis for the kids. The NDIS (the disability welfare organisation in Australia) refuses to recognise her diagnosis because she doesn't have a genetic test proving it, even though there IS no genetic marker for hEDS. So yeah, it's utterly ridiculous how many Zebras struggle to be recognised (particularly those with hEDS which ALSO happens to be the most common form).
You say thousands of caths, so I suspect you've had at least one EDS patient, even if you (and maybe they) didn't know it. Turns out Zebras are more common than people think. For some reason, a lot of people assume that to have EDS you must be tall and spindly, but that's Marfan's syndrome. The various types of EDS don't all cause that same Marfanoid appearance (and yes, I know a family with three Marfan's people in, too - mom and two kids). You tend to find others with those conditions when you all suffer the same kind of dysautonomia.
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@Nagendraprabhu In older people, especially those who work their body hard physically, most arthritis would be osteoarthritis - it's just wear and tear on the joints over time, and it wears down the cartilage in the joints, causing inflammation, pain and stiffness - and in bad cases deformity. There is no cure, really, but medication to reduce inflammation, gentle exercise and other lifestyle changes can help. As for bow-leggedness, that would depend. It could be from their joint damage, or it could be a nutritional deficiency, but that more often shows itself in children (Rickets).
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Gastroparesis sucks so badly. I'm guessing you tried the usual suspects (erythromycin, metoclopramide, domperidone etc)? My transit time is SO slow, and I agree, bonus fibre doesn't actually help for me, either, it just means more to come out which is even more painful and difficult. The only thing that seems to help is Movicol, but even then, it's such a pain to tweak the dose when your gut transit time is measured in double figures of days. Honestly, though, I've kinda got used to that end, it's the endless nausea and vomiting that makes me crazy.
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@kimberleyike2168 It's not that easy, though. Most people don't consciously say "I'm not gonna poop/pee" and in fact can try really hard, strain super hard trying to go to the toilet, and fail miserably. It's a subconscious response from your body where the sphincters and pelvic floor refuse to work and co-ordinate to let you use the toilet because of underlying anxiety. And even though anxiety is the underlying cause, telling someone to "just go" is like telling someone with vaginismus to stop being in pain trying to use tampons or have sex or a pelvic exam because of spasm of the muscles around the vagina or telling someone with IBS to stop having gut cramps or diarrhoea because their bowel contracts too hard and too rapidly. It just doesn't work that way for many people (and it isn't rare).
While people on the milder end of the scale can overcome it by covering their ears, playing music, finding a quiet bathroom etc, many people can't, and in the worst cases, they can end up having to literally insert a catheter into their bladder multiple times a day because they go into full blown urinary retention, or retain stool for so long they end up faecal impaction and developing megacolon because the bowel overstretches and the contractions become weaker, and this can take YEARS of regular therapy and medication use to resolve, if it ever does.
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The medical term is parcopresis (and the same for peeing is called paruresis). They're forms of social anxiety and the method of treatment usually involves exposure therapy (not literally - you start by letting someone you trust get closer to you when you're in a safe bathroom until you feel able to go and try in an empty public bathroom etc). But for some people, it can be so severe they simply can't go at all in public - a small number of folk even have to use intermittent self-catheterization if they can't overcome their body's response to let them pee in public, because it can cause real problems - aside from discomfort, there's the risk of UTIs, constipation etc. But I definitely recommend that if you're suffering from a shy bladder or bowel, that you go look up some of the support sites and maybe see your doctor if it's really affecting you (i.e. you can't go out because of the anxiety, you're not peeing all day etc). I say this as someone who used to have the WORST case of paruresis and parcopresis as a child and teenager (and even now, as an adult, I am still not completely free of the anxiety, but I can, at least, use the bathroom when I need to). At least, as long as I don't have to deal with having diarrhoea. Then the anxiety comes back REALLY badly.
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@bossladie909 Jesus that's awful. At the end of the day, it doesn't really matter WHY, only HOW. If you are prone to infections, there is a medication you can ask for if you haven't already tried it - Hiprex, aka Methenamine. It works as effectively as taking prophylactic antibiotics, but because it isn't an actual antibiotic, it's much less of a problem than using long--term antibiotics. I finally was given this about 18 months ago, mid-Covid crisis, and prior to that, I was going from one UTI to the next, and each one needed a week of cipro (a very potent antibiotic with potentially life-changing side effects) just to clear things up for a couple more weeks. It was frustrating and painful and exhausting (and was worsening my interstitial cystitis as well, because my bladder was so inflamed). Sepsis from a UTI is so miserable - been there twice, definitely trying not to go there again. I don't think a lot of doctors truly understand how badly uro issues can disrupt your life and make you feel so utterly miserable. Surely urodynamics would show if you were retaining too much urine or if your bladder wasn't reacting properly, and if that's the case, either medication or even teaching you how to do intermittent self-catheterization would be options, depending on what the exact issues are. I'm so sorry you feel like this - I know it can be so hard to convince doctors that there's something really wrong, and it shouldn't be that way. Sending good thoughts your way, and I hope you find some answers (or at least better management) soon.
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Ahh ok, I had to dig back into my anatomy classes for this. The mitral aka bicuspid valve between the left atrium and left ventricle, the aortic valve between the left ventricle and the aorta, the tricuspid valve between the right atrium and right ventricle, and the pulmonary valve between the right ventricle and the pulmonary artery. All the valves have three leaflets except the mitral, which only has two, hence the name. The leaflets are attached to the heart by the chordae tendineae and the papillary muscle. In about 2% of people, the aortic valve only develops with two leaflets instead of three, which is called Bicuspid Aortic Valve Disease, and that can cause aortic stenosis (narrowing) or the valve to leak, leading to regurgitation of the blood in the aorta, and if left untreated, it can lead to heart failure. Most of the time, this end up needing either a valve repair and/or replacement via surgery.
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I'm sure the video they're making will be much more useful, but the problem with steroids long term is basically that it works by suppressing your immune system to reduce inflammation. Unfortunately, that makes you more likely to get infections etc, and on top of that, because corticosteroids in the body are used in a lot of processes, it also messes with those too - for example, it can cause osteoporosis, too, etc. It's a powerful medication that acts in very broad strokes, and so when used systemically, it causes these problems. It's not so much of an issue if you're using steroid creams, inhalers or nasal sprays, but it can still thin tissues etc. Another big issue is that if you take steroids long term, it can suppress your own natural corticosteroid production in the adrenal glands. Stopping suddenly - particularly of a long-term, large dose - can send a patient into a huge crisis and potentially be very serious. This is why if you take oral steroids long-term, you should make sure that you are carrying something that can inform emergency services that you use them, as it may affect not just their treatment of you, but ensure that you don't end up in a crisis because they don't know to keep giving you the steroids while you might be incapacitated and unable to tell them so.
That said, if you need them, your doctor has probably decided that the benefits outweigh the risks, and that's the issue with all medications. Balancing the risks and the benefits, and deciding on an individual basis.
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Not saying this was your intent but I just wanted to clarify (for everyone) that being autistic doesn't automatically mean you lack empathy. I know this is a commonly spread misconception, even by medical professionals, but it's simply not true. A lot of autistics struggle with identifying emotions (alexithymia) and many more struggle with explaining their experiences and feelings to allistic people - it's kind of like one person talking in French and the other talking in English and trying to make sense of each other with only a couple of years of school language lessons, no clue about differences in social behaviour, idioms, etc. But plenty of autistics feel an excess of empathy, even for inanimate objects.
Also, AFAB autistics are often misdiagnosed or go undiagnosed well into adulthood, or they get misdiagnosed with (drumroll) BPD. Honestly, ALL BPD is basically a trauma response and I personally see very little difference between that and cPTSD in a lot of cases. But it seems that the medical community likes to slap a BPD label on a lot of AFAB folks regardless. If you haven't already done so, it might be worth looking at what is often termed "female" autism, even though neither gender nor autism presentation is binary. I know plenty of AMAB individuals that went undiagnosed too because they also didn't fit the "classical" autistic profile which , honestly, is biased in so many ways because it's based solely on a small number of middle-class white boys from many, many years ago. You never know - you might find that it rings a lot of bells for you, but it might not. Just wanted to add my two cents as an AFAB autistic with a shit-ton of childhood trauma and cPTSD
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@Da Booty Hole Lover It really isn't THAT rare, though. Exact numbers vary, but it could be up to 16.4% of people dealing with some degree of parcopresis (shy bowel) and around 7% of people dealing with paruresis (shy bladder). For comparison, asthma affects about the same number of people as paruresis, and IBS affects around 15% of people, and a woman's lifetime risk of breast cancer is around 16%. It's thankfully relatively rare for it to go to a serious level in adults, but it's absolutely not rare in kids, and problems with withholding poop and chronic constipation, as a result, are super common, in toddlers.
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@Da Booty Hole Lover Or, they just haven't told you. That's the point. Diseases, disorders, disabilities - they can all be hidden. Just because you haven't heard of them, or known anyone with them, doesn't mean they're not real and even fairly common.
And, by the way, I have ALL of those diseases so hi. waves
When I was younger, I literally couldn't pee even in my own bathroom if anyone was around. THAT is how bad my paruresis was. I have, more than once, only peed once in 24 hours. And I absolutely couldn't poop for days at a time whenever I stayed away from home. Even at home, I would have to make an excuse to shower/bath to give myself the excuse to have all the water running just so I could sneakily use the bathroom in my own home. And I wasn't nearly as bad as some people are.
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@Da Booty Hole Lover As I mentioned, paruresis and parcopresis are primarily social anxiety disorders - there's a conscious or subconscious fear of being heard or seen, then being judged or laughed at or ridiculed or whatever. Guys often talk about "performance anxiety" when they have to pee in a busy urinal because it's generally not socially acceptable to just stand there doing nothing, which is a vicious circle, because the more anxious you are, the more you're likely to clench up. But it's not always a conscious thing. Even knowing that everyone pees and poops, and it's no big deal, that doesn't necessarily make the anxiety go away. Especially when even though the original trigger was some kind of shyness/self-consciousness or whatever, it can morph to the point where you're anxious about not being able to go, and that's a self-fulfilling prophecy.
The first thing to do is to see the doctor and exclude any physical causes that might be causing or worsening the issue. Once those are excluded, then the first thing would probably be to try exposure therapy. Find someone you trust, explain to them the issue, and start off using the bathroom with them in the next room, or outside, and then over time, they get closer to you until maybe they're right outside the door or whatnot, and then you move to a quiet "not safe" bathroom, taking them for moral support, and again, have them get closer and closer until they're right outside and you can still go. Along with that kind of exposure therapy, there is breath-holding technique that can help some people because it causes a reflexive relaxation of the pelvic floor muscles that you use to stop yourself going to the bathroom. A doctor might prescribe medicines to help with anxiety if you're generally struggling anyway, and they can refer you to a therapist for CBT or the like to try and manage the underlying anxiety and fear. And in the worst cases, some people have to use intermittent self catheterization, where they place a tube through their urethra into the bladder several times a day in order to fully empty the urine. This is pretty rare, to be that severity, but if it's a case of that or repeated infection, urinary retention or not being able to even leave the house to work or go to school, then that might prove to be necessary.
Most of that also applies to a shy bowel as well, along with the use of medications to help keep stool soft and to encourage regular emptying of the bowel, as well as bowel training to teach your body to poop regularly (such as after meals, when you wake up, etc) at a time that is appropriate for the person to be in a safe bathroom initially - and once they complications of withholding like constipation, fecal loading, etc are under control, and the person is able to poop regularly in a "safe" bathroom, then you can work on making it possible for them to go in other bathrooms.
Sometimes, just realising you aren't alone and that other people also struggle with these issues (especially, but not only women) and being able to talk openly with others on a support forum etc can be enough, provide you with understanding about why it happens, and allow the person to pick up some self-help tips (like listening to music on headphones, visualisations, relaxation, etc).
I hope that helps.
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