Comments by "Just Another Bucky Lover" (@JustAnotherBuckyLover) on "Institute of Human Anatomy"
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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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