Does paracetamol increase ggt

Hello! my GGT level increases from month to month by an average of 50. 7 months ago GGT was normal. Does anyone know how can I lower GGT? I'm on UDCA... You can forget about Vanco in Europe.

Hey all, just wanted to a share a very quick overview, thoughts, and concerns 1 week after having a microdiscectomy on my L4-5 disc last week. I am now coming up to 7 days post op, feel free to ask questions if you have any. I've attached my pre-op scans + radiologists report too, for those who are interested.
I also have some questions at the end for those who have had a MD before that I'd love your take on :)
History TLDR; sciatic pain for ~3 years, started as leg pain when extending whilst sat down, progressed to severe, constant, lower back pain and leg pain when performing any activity other than laying down on the floor.
My surgery lasted for 2 hours, and was in the hospital for a total of 2 days (1 night stay). The hospital bed + assistance from nurses was highly appreciated. As the hospital beds are adjustable, it helped reduce pressure on the wound significantly. After having the procedure, you will be unable to bend to put on socks - it helps to have a second person to assist. The incision site is still very sore, and my back feels bruised, but no complications. The incision is around 5cm.
I have now completely trailed off all of my pain medication. I was on 150mg Tapentadol and 3000mg Paracetamol daily, and the pain was very manageable. My lower back pain has completely gone, I can now sit without pain (except for some soreness around my incision site + muscle aches), but still aim to keep sitting no longer than 30m at a time.
My sciatica went away initially, but has come back slightly since the operation (~60-80% reduction in pain from pre-op). I personally put this down to a mix of coming off pain killers, and increased inflammation. I am scared as hell that it is a sign it won't go away - I know this is just anxiety talking though, as I feel I'd know if I reherniated. From what my physio has said and what others report, it can take a few weeks to a few months for the nerve pain to resolve.
My other associated symptoms have almost completely subsided. Pre-op, I had sporadic difficulty urinating, numbness and tingling in my saddle region, which has now disappeared. I did have pain in my groin/bladder a few days post-op when urinating, but that has subsided, too.
I have been doing the following exercises 3 times daily, I am able to perform these with minimal pain and they really loosen up my back and post surgery stiffness:

• 2 sets of 10 ankle pumps
• 2 sets of 10 heel slides
• 2 sets of 10 single leg knee hug
• 1 set of 10 neural glide
• 2 sets of 10 sit stand from a chair
• 2 sets of 10 sideways walking

Overall, I would put a strong recommendation on the microdiscectomy procedure. If a MD has been identified to be beneficial to your diagnosis, and you feel you have exhausted other options, go for it. I wish I had it a year ago, it would have saved me a lot of pain and likely increased my chance of a positive overall outcome.
Questions I do have for others who have had a MD:

1. How long did it take for your sciatica to improve post-op? For me, it flares up the most when doing single leg raises. Stretching does help to reduce symptoms.
2. For those who have re-herniated; how obvious was it? I keep getting the niggling anxiety that it's already happened and that's why I still have some sciatic symptoms.
3. Did you get other odd pains that weren't there before? As I mentioned, I had groin/bladder pain for a few days post op. I have also found that my shins have started hurting, where they didn't before.

https://preview.redd.it/tq5av1xjvd0d1.jpg?width=1044&format=pjpg&auto=webp&s=d12261ee66910d862ec78bc965e1cf493257bbb3
https://preview.redd.it/e78073xjvd0d1.jpg?width=1174&format=pjpg&auto=webp&s=3d630e53cbb8287e1817d3079d4e28d32fb99feb
https://preview.redd.it/tnfaw1xjvd0d1.png?width=1290&format=png&auto=webp&s=729372c34c280e2c20e68e33ae96edbd7bee5eb6

hey! i’ve been on paroxetine for almost two weeks now, it feels great! are there any painkillers that are safe to take with paroxetine? i tried to do some research and it says that ibuprofen may increase bleeding but the only ones we have in my country are ibuprofen and paracetamol so im wondering if they’re generally safe to take? does anyone have any recommendations or experiences?

TLDR - They say an image is worth a thousand words.
Wealthy Exile Graph
I went from a respectable stash value estimated at 365 divines (that's raw currency, not including character investment), and nearly doubled that to around 615 divines in about three days, all thanks to a very simple crafting strategy: creating 3-mod fractured boots with a focus on getting chaos resistance, movement speed, and life (in that order).
Now I have to admit, my early league experiences with graveyard crafting were absolutely terrible. Sitting idle in my hideout would have been a better use of the time I wasted in the Necropolis. However, I knew that the potential was there for making great items, if I could only gain some experience in its proper use. So I resolved to learn about the mechanic once I had some spare time, and had farmed up enough initial materials to try and build a full graveyard on my own. Opportunity came knocking when I needed some upgraded boots to start switching to an omni build (and unfortunately – or fortunately I guess in the end – no boots existed for sale in SC trade with the mods I wanted). So I went on craftofexile and slapped together a quick and horribly unoptimized necropolis recipe (the web interface on that site for crafting with coffins is not very intuitive I must say, but in giving us a functional tool for a temporary league mechanic I won't complain), and despite my amateurish fumbling in theorycrafting my first graveyard, I got lucky on my very first try!
Necropolis Boot Craft Result 01 2024-05-04
I finished off this craft by using a Deafening Essence of Loathing and bench crafting a blocking prefix then exalt slamming a suffix, which landed me something valuable on the first/second attempt I think. However, it wasn't what I needed for my build, so I replaced the blocking prefix with a better bench craft and decided to just sell those first boots and try to craft another. I mean, it it seemed so easy, right? Yeah...not so much. It turns out that getting those three fractured mods is not a guarantee by any means. At best the craft seems to land at around a 26-27% success ratio, which was worse than I had first hoped. So I unfortunately whiffed on my next 5 attempts, which was frustrating. Though that turned out to not be so bad in the end either...but more on that later.
Here's a screenshot of the first sale I made, to show the kind of final crafted boots I'm talking about.
30 Div sale
These boots sold almost instantly for a hefty 30 divines, so obviously I was encouraged to do more. Before I get to the results of all the crafts I did, here is the crafting process I used. First the graveyard craft itself:
Graveyard craft
Note: this is probably version 7 or so of many different iterations I tried with different mod weightings, after learning about what worked and what didn't within Necropolis, and once I got better at target buying the final materials I needed.
This graveyard isn't optimized to min/max coffin placement with row/column boosting or anything like that. I just wanted a simple, relatively cheap method that didn't take a lot of planning (the common components in this configuration don't really warrant the extra expense anyway). My goal was to be able to slap down coffins as I acquired them, placing them wherever an open grave existed until I could pop out a new set of boots every few hours or so. Craftofexile gives this configuration a bit better than a 1 in 4 success rate (which is around what my small sample size worked out to, though my initial "slapped together" badly done recipes were probably closer to 1 in 5 odds or thereabouts). The great thing about this craft though was that even the whiffs turned out to sell for a nice profit (see the full album of sales below).
First, here is a (hopefully) detailed crafting guide:

1. Craft the boots in the graveyard using something near the recipe I've shared (a different non-Evasion base can of course be selected and still make a profit, but if you don't choose a dex/evasion base, the boots cannot roll the valuable Spell Suppression mod later in this process...just FYI).
   
2. Use a Deafening Essence of Loathing (3c each...very cheap this league) on the boots (or a different essence if you want some other mod besides elemental avoidance). The three fractures work great with the essence, since they mean you most often end up with just the 1 added essence suffix, which makes the next steps super easy. If you happen to get extra prefixes and suffixes after the essence is applied, you can try annulling them off (I had way more annuls than essences sitting around, so using an annul made economic sense for me, but if your essence is less than 5c in value, you're likely better off just applying the essence again). Whatever you do, you are looking to have just the essence mod before continuing to the next step (unless of course applying the essence gives you a valuable fifth or sixth mod already, but that is very unlikely, so I'll assume an exalt slam is needed moving forward in this guide).
   
3. How you continue now depends on whether the fracture began as a 1 Suffix 2 Prefix item (the best config), or if it's 2 Suffix 1 Prefix. Let's start with the more valuable 1S2P case. You want to bench craft a cheap blocking prefix mod (like 25-34 mana, which costs 3 augments) and then exalt slam a suffix. You're looking to get T1 light/cold/fire res, or T1 dex (T1 stint mod(s) on a different base) from the exalt. The holy grail is of course exalt slamming T1 spell suppression on dex boots. Tier 2 of any of these mods is still quite valuable, so the great thing about this craft is that there's a wide range of decent suffix results that you can get. For the 1P2S case, the goal is a bit simpler. Depending on whether movement speed or life is missing as a prefix, the goal is just to exalt slam some prefix that isn't a low roll of those, and that isn't terrible. So I would again block Mana with a cheap bench craft, and then exalt slam and accept anything that wasn't the lowest tier possible, and then replace the temporary bench mana craft with whatever was missing between movement speed or life. There's nothing much to be gained from multiple essence and exalt slams in the 1P2S case, so I'd keep the costs low and not bother with more than a few attempts in this case. Considering the wide range of good results in both cases for this step, I ended up spending around 100 essences and 70 exalts in total over the 13 boots I crafted to produce something that could sell for multiple divines. The handful of annuls I used on occasion aren't worth factoring in to the costs. YMMV, and there can easily be a bad run of wasting 10+ essences at this step, but in practice I often hit something good in the first two or three tries. That's around 50-60c average cost to get an acceptable second prefix or suffix mod on the boots.
   
4. After repeating step 2 and 3 until you've hit something good, you then bench craft on a good final prefix to replace the blocking mana mod (I chose evasion/life for this). In order for the item to sell, I recommend you finish the craft with some eldritch currency. Trying to sell the fractured base raw without essence or eldritch mods is probably going to be very hit and miss (mostly miss), since buyers prefer a finished item. Luckily I had a bunch of eldritch orbs on hand to spare, so I crafted lesser prefix mods on every pair of boots I made (except one where I accidentally selected greater eldritch embers...no big deal, it only took a few tries to hit something good, at which point I realized my misclick). The list of acceptable exarch mods was as follows: action speed, movement speed, chaos res, onslaught effect. Acceptable eater mods were: cooldown recovery (travel or global), avoid ele ailments.
   

Using the above process, here's a gallery of all the subsequent sales I made after the initial 30div sale:
29 Div sale
22 Div sale
20 Div sale
13 Div sale
9 Div sale
7 Div sale
7 Div sale (different item)
6.5 Div sale
4 Div sale
And finally, the boots I wanted for myself finally popped out on attempt #12!
Agony Stride
I could probably sell these for 50 div (or maybe more) if I wanted, even though they don't have perfect T1 spell suppression. I'm happy enough wearing them right now though, so they're not for sale at the moment. Two other boot crafts that were very bad whiffs haven't sold yet, but I think they should make a couple div each when/if they do sell, which should at least cover my costs for those two graveyards. Overall, this craft seems reasonably close to being guaranteed profit, at least based on my limited results (of course market conditions may change if crafts like this start flooding the SC trade site).
If anyone wants to try this for themselves, here's a screenshot of the coffin shopping list from the sudos graveyard that I built:
Coffin Shopping List
Again, the nice thing about this craft is that you can just throw the corpses in any available grave, without too much that can go wrong.
And now a long and verbose list of all my lessons learned while exploring this mechanic. Graveyard experts and anyone who isn't interested in reading my tales of sorrow and woe can probably ignore the rest of this post. :-) Those who are interested in trying this out and are unfamiliar with how the graveyard mechanic works should take note of the many mistakes that I made though.
An important note about the shopping list items: only two +Item Level coffins should be needed, as long as one of the coffins buried is ilvl 84 and none of the other coffins go below ilvl80 (this is based on my general understanding of how crafted ilvl seems to work, and what showed for me in the item properties as I buried different ilvl coffins in the graveyard...unfortunately, there's no real clear FAQ around this that I could find despite much searching, and I don't claim to be an expert on the mechanics, as I'm sure this craft is not 100% min-max'd...but the great thing – once again – is that this configuration doesn't need to be perfect to produce sellable results, as shown by the variety of sales I was able to make even with only 2 of the desired mods). If you only use ilvl 80-83 coffins, you'll have to replace one of the non-mandatory corpses with a third +Item Level to get the boots to ilvl 86, or else they can't hit the "35% movement speed" that this craft guarantees.
Another note: the shopping list from sudos is a bit misleading in spots. For some reason it says 87 trades are needed, but if you add up the actual numbers the graveyard I built is full at 88 coffins. Not sure why the summary section thinks one coffin is missing. Also, the estimated prices for coffins are much higher than I ever paid for materials in my experience. I guess if you bought everything in bulk for an instant graveyard the total cost could end up in the 7-10 div range, so that may be why it shows that high estimate. However, I was able to buy things much cheaper in a reasonably short period of time by grabbing singletons and small bulk sales (interestingly, large bulk sellers never seemed to respond to my whispers for coffins compared to normal trade site whispers...that lack of a response was consistent even when trying to buy bulk at over double the price that I was usually willing to pay, so overall I found way more success using methods like live search to pick up individual corpses than any other manner of acquiring the coffins I needed). The chaos and fracture coffins make up the majority of the cost of this graveyard, so they are the priority when buying materials. I could usually pick up the 32 chaos coffins for around 3-5c each, even in bulk. The 12 fracture coffins ranged from 10-15c each (those prices were a bit more volatile and sometimes jumped up to 20c). The speed coffins cost about 4-5c each. So again, the sudos pricing is very misleading and far too expensive IMO. I estimate that I averaged around 3 div in final costs for each graveyard, once I had a handle on the best configuration for the craft.
Basing my total costs on that 3 divine average would put my expenses at 39 divines for thirteen graveyards over the course of several days. My total revenue was approximately 200 divines from the resulting items (150 divines earned in sales plus an estimated 50 divine item that is being used on my build). That means I turned a profit of around 160 divines using this strategy! Those are pretty good numbers I'd say. The wealthy exile graph does show a much larger jump in wealth than that, to be fair, but to be completely transparent that jump in wealth also includes my normal mapping profits over that period. And that's the kicker in all of this: I was actually focused for the majority of the three days – Friday, Saturday, and Sunday – on just running maps, during which I farmed up 4 veiled orbs and a valuable assortment of div cards, scarabs, and the like. I only built graveyards as a break between chaining maps and while cooking meals/eating, and late in the day when I didn't have the energy anymore to rush maps, etc. Considering how those 4 veiled orbs were selling at 13 div on the weekend when I took the wealthy exile screenshot, and they are now estimated at 16 div apiece, though actual selling price is probably a few div higher atm, that's a lot of primary profit while getting graveyard revenue "on the side". Also, I modified my atlas to run a sbox/betrayal/necropolis strategy once I understood the true value of the graveyard mechanic, and I ended up selling a bunch of meatsack allflames (5 for 8 div) as well during this switchover in strategies. Plus there were a lot of other profits from other sales. Anyway, all that I'm trying to say here is that the wealthy exile numbers from the graph aren't very exact in terms of estimating the graveyard profits alone over these three days, given my actual playstyle was not focused on building graveyards.
One bad mistake I made at the outset of this, that I do want to share with anyone trying this kind of crafting, was to try using the "Increased chance for prefix modifier" corpses. I was disappointed when they didn't seem to help much in giving me the two prefixes and one suffix crafts like I was hoping they would (again, the most common way this craft "whiffs" is by producing two suffixes and one prefix). So I posited that weighting for more prefixes would give better odds to the craft. However, I have learned since that the "prefix" corpses don't really function as I had hoped they would, and they ended up working against the "rarer defense" corpses I was burying by increasing the defense mod weighting, and adding weight to all the possible prefix mods, which just muddied the overall pool in unwanted ways. It didn't seem to hurt things too bad in practice, and I had reasonable successes while using a few of the prefix corpses, but as I upped the number of them in my early graveyard testing and got a couple of unexpectedly poor outcomes, I chose to remove them in my later iterations after researching the actual function, and – most importantly – after understanding from the sales what was vital in achieving value.
Because the mod priority in this craft is clear and unequivocal: chaos res >> movement speed >> life. It's easy to bench craft high +life on boots if that mod is missed. The lack of landing 35% movement speed is a bit of a downer, and it's not ideal of course, but it can be reasonably fixed by bench crafting a movement speed/onslaught mod, and the boots will still sell for a tidy profit (as shown by one of my sale screenshots above). So the prefix mods are actually the lower priority in a sense, even though you want to get two of them in the best possible case. In the end, it's the lack of chaos res that can't be replaced with a bench craft. So that's why I settled on using a whopping 32 corpses of "inc% chance of chaos res", and accepted whatever RNG decided between getting 1P2S or 2P1S splits. That many chaos coffins is admittedly a large amount to have to gather, but it should give slightly more than 9 in 10 boots that land the much sought-after chaos resistance (I ran a few simulations in craftofexile around this), which from my experience is crucial in getting the expected profit out of this craft.
When pricing items to sell, I chose to be very aggressive to try for quick sales. I started out at exactly what I thought the boots might be worth, and kept lowering the price every half hour or so while going back and forth from mapping. If someone whispered a reasonable offer to me that was below my set price, I just accepted it and didn't even bother haggling. So don't take the screenshots I shared as the absolute value for each item; I suspect a few of them could probably sell for a bit more if I had tried to wait or barter a bit.
Finally, an important lesson I learned in my crafting attempts is that the "Reroll explicit modifiers 6 times" corpse does not affect fractured modifiers. Unfortunately I wasted a few of those coffins – and the opportunity cost of using that grave slot for adding more chaos res weighting – on my first couple of attempts, until I realized they were doing nothing based on the low fractured mod rolls I would sometimes get. I later confirmed that fracturing happens before rerolling, from reading a few forum posts that explained the functioning of the mechanic. At least I know I won't make that mistake ever again.
That's everything I can think of to mention. Thanks for reading all the way to the end!

Hey all - I had an IUD fitted today as part of my perimenopause treatment and thought I'd share the experience. As a 37-year old, I'd never had an IUD before so didn't know what it would be like, and thought I'd share in case anyone else is facing a similar treatment path!
Below is long, but I wanted to give a detailed account. I hope it's helpful to somebody (and doesn't break any rules, mods!)
Background
I was recently diagnosed as perimenopausal at the age of 37. I had loads of symptoms, but key among them have been heavy, clotty and increasingly painful periods, and very irregular cycles (anything from 10 to 40 days) over the past 18 months or so - despite being on the progesterone-only pill (which can actually stop periods in some women.. but obviosuly not me, lol).
After eventually getting a referral to a gynaecologist I was diagnosed as perimenopausal and they recommended I start HRT. Given my medical history (previously had received combination BC pill but had to stop as I was getting migraines) and period troubles, they recommended a topical (gel/lotion) estrogoen, and a progesterone coil (Mirena). So I got myself booked into the sexual health clinic for a coil to be fitted.
Before the appointment
I took 1000 mg paracetamol (acetominophen) about an hour before the appointment and made sure I had some breakfast (honestly, I think they recommend the painkiller this more for the cramping pain you get afterwards, rather than the pain of the actual insertion).
The insertion is a similar set up to getting a smear test, so if you'd feel more comfortable wearing a dress or skirt consider that (I figure, my fanny is going to be out no matter what, so I opted for leggings as I find these comfy even if I'd have to take them off completely). I also packed a sanitary pad as some bleeding can happen, and in my country the pads the free clinics give out are massive and have no wings, and I wanted to be confident in my pad's abilities!
At the appointment
After checking into the clinic and waiting a few minutes, a lovely nurse came to collect me and took me back into the treatment room/office. She sat me down and asked a few health questions (about my periods, what contraception I was currently using, sexual health/partners, if there was a chance I could be pregnant, etc.), then talked me through potential side effects and risks of the procedure. This (and my experience of it!) was as below:

• Undressed (pants/trousers and underwear) behind a curtain, and lay down on the bed. I was given a large sheet of paper towel to cover myself with. At this point, a second nurse joined to assist in passing various bits to the first nurse, and check on me while the insertion was going on
• Bend knees and place feet onto special pads or stirrups
• Internal exam conducted (nurse inserted two fingers into vagina to check vaginal canal and cervix), and also palpated (pushed) on pelvis above where the uterus is - this took maybe 5-10 seconds tops, and was a little uncomfortable - about the same discomfort pain as getting a smear test
• Speculum inserted and opened - this was kind of uncomfortable, and felt like a kind of pressure, but was familiar from smear tests
• Before fitting the IUD, the nurse has to measure how deep your uterus is so they know how far to push the IUD in. To do this, they use what essentially is a thin plastic stick with a ruler on it. To get this into your uterus, they obviously have to go through the hole in your cervix. As part of this, they grip the cervix with a pair of forceps, and gently pull to hold it in place. I thought this would be the most painful part, but honestly it wasn't much worse than the speculum in terms of pain levels
• What I did find painful however was when the measuring stick touched the top of the uterus. At this point there was a pretty substantial stabbing, cramping feeling. It was painful enough to make me say 'OUCH' out loud, and I found I was getting a bit upset and having to breathe through the pain, as it did last for a little while (probably only around 10-20 seconds, but at the time it feels like longer)
• I have a pretty high pain threshold (I can get piercings and tattoos without blinking an eye, pretty sure I've hairline fractured some digits and never sought treatment, repeatedly had some bad sprains, sliced my palm open and pain was manageable, etc.) but I have to be honest... this was pretty bad. It's probably some of the worst pain I've had, but I would rate it a 6/7 out of 10 on a pain scale - I could go worse before having to stop and give up and explore getting it fitted under sedation, for example
• Once the nurse has the measurement, they take the IUD fitting device out of the box. It comes in a sort of long plastic tube with the little arms folded down flat so it can pass through the hole in the cervix. Once again, they clamp down on the cervix, and push the tube through (they had to switch to a slightly smaller IUD at this point as the original one they wanted to fit was too big to fit into my dainty womb apparently!). And again, the worst pain was when they made contact with the top of the uterus and opened the IUD up
• The tube and speculum are removed and that's it - it's fitted. The whole insertion process took maybe 5 minutes, but it was uncomfortable and there's the usual 'fanny out in front of strangers who are digging around down there' awkwardness

The nurses were great throughout, they were very kind and calming, checked in on me often and told me what they were doing at each step.
If you are interested, there's a sort of training animation available online you can watch: https://www.youtube.com/watch?v=aVZoH0Pda-4
Afterwards & next steps
After it was inserted and they'd closed the curtains, I was able to lie there for a while and recover. I sat up slowly in case I felt light-headed (nurse said I might), but I was fine. The pain was now more like bad period cramps - painful but not as bad as the stabbing pain during the insertion. I would say if you are used to bad period cramps it would be familiar pain. Using my pain scale I'd say they were a 5/6 out of 10.
I put my pad into my underwear and got dressed. The nurse gave me some leaflets and a reminder card, reminded me to take pain killers and advised that I give it about 30 mins before driving home.
I left the clinic and walked back to my car. I was pretty uncomfortable so I sat in there for about 20-30 mins. The cramps were coming in waves, and after a while I had to get home so started driving. I was safe to drive but I felt a bit drained after it all, so you might want to get a friend to drive you if you can.
Since then, the cramps have been getting better. About 6 hours from the insertion and the pain is down to a 2/3, and still coming in waves, although they are further apart. I have doubled up on painkillers though to help - 3 hours after I took that first paracetamol/acetominophen I took 400 mg ibuprofen, and am keeping up with painkillers according to the dosing instructions they come with. I've had a hot water bottle on my tummy to help too. I've felt a bit nauseous, but have made sure to eat.
I have had some bleeding. Not a lot so far - it's more like a sort of spotting bleeding, but it does look as though there's some endometrial tissue in it (which would make sense seeing as my uterus has been repeatedly poked!).
Stupidly I didn't take the day off work - I kind of naively thought that the worst of it would be at the point of insertion. I'm working from home, but I am defintiely not as effective as I normally am, and I could have done with having the day for rest and some self-care. If you are getting an IUD fitted I strongly suggest taking the day for yourself if you can.
The coil should last about 8 years before it needs removing/replacing (unless something happens in the meantime).
In a week I have a call with my doctor about starting the oestrogen.
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As I say, I hope this was helpful. I'd be happy to answer any questions if anybody has any!

Hi Guys, I don't post in Reddit often so excuse my lack of Reddit formatting if that's a thing. I am just looking for some advice about medical negligence as I believe I have a case but am unsure. I'm sorry its a long story too but the details are relevant. So basically, last Tuesday I brought my 11m old daughter to A and E as she was really unwell, unsettled and super lethargic with a temp of 38.5C. She had a slight cough and a rattly chest with a completely diminished appetite and mottled skin. They checked her over then admitted her to Peads with a view to a more thorough exam. We got her temp under control with paracetamol and ibuprofen and then were sent away with a throat numbing spray and a "must be viral" diagnosis. I asked if they would please xray her chest but was informed there was no need, she will be fine in a few days. I asked for antibiotics as a precaution and was told no. Wednesday rolls around and again her temp shoots up to 38.8C. Calpol not reducing so I brought her back to the ward, same thing happens again (temp controlled, no you can't have a chest xray, it's viral, nothing more we can do) I requested to stay the night for observation and this was allowed. They checked her obs maybe twice overnight and told me in the morning she was fine to go home. Following medical advice I did my best to control her temp at home with fluids, analgesic and cooler home temp. This continued until Sunday. I was then super unhappy with how she looked still lethargic, not eating and roasting hot. I called 111 who made an out of hours appointment and when we arrived they temped her at 39.8C. We were admitted again and this time they listened to me and xrayed her chest "to be on the safe side". This revealed a raging chest infection causing clinical pneumonia and it was observed that her breathing was laboured. She was hooked up to oxygen, started on antibiotics, oxygen wasn't increasing her o2 Sat's so eventually she was put on optiflow (the step before a ventilator basically) We are still here and this morning we discovered that she has so much infection in her that her middle ears filled with enough pus to burst both her eardrums. Basically my baby girl is super poorly and in the hospital for the foreseeable until she can be weaned off a breathing machine and will need further follow ups to check for any lasting damage. All of which I feel could have been avoided if I was listened to on the Tuesday in the first place.
So I guess my question is, could I take this further? Does anyone have some advice for how to go about it? Any help gratefully received X ETA- I'm in Scotland Also TL:DR- baby girl is severely ill because doctors didn't listen to me the first twice I brought her in

I have type 1. Diagnosed at 8 years old and I'm 21 now, and my pain is increasing every day. I have an MRI scheduled for the next few weeks, but I'm so scared I'm going to have to get surgery or rely on painkillers my whole life. Does anyone have any pain relief methods? I've heard cannabis helps but I'm unsure on if I want to go down that route. Breathing seems to make the pain worse, and no painkiller (paracetamol, ibuprofen and those mixed with codiene) seems to help. If anyone has any advice I'd appreciate it a lot. Thank you in advance 🩷

I've never written a reddit post before but I figured I finally would because honestly I'm so tired of being tired and I've seen posts about CFS that are so relatable and finally feel understood.
Okay so, I was diagnosed in 2017/2018 after contracting glandular fever after tonsillectomy complications. Now I am 18 and somehow it feels worse than it did a year ago? Around the time I was diagnosed, it was muscle aches/fatigue that was the main issue until it was extreme fatigue and inflammation in knees which made going up and down the stairs painful for a while.
After seeing a doctor about that, they said just take paracetamol lol and after a while that went away. The other most debilitating symptom I had was like...heat exhaustion? basically it felt like my body was on fire, i'd rock back and fourth every night because it was worth in evening like being in extremely hot, intolerable weather even in winter, sweating like crazy. Night sweats were awful. I went to doctors and had blood tests and they said it was hyperthyrodism and after 2 years or so it eventually went away but I cannot stand it when heating comes on. Or in summer I will still spend most time indoors because heat is too much and increases fatigue.
In the last 3 years there has been one symptom that I still can't understand. Apologies for such a long story but here we go - One halloween I suddenly had extreme squeezing pain in my leg. It was excruciating to walk and made me cry and I was supposed to go to a haloween party later on. So when I got home I just lay on the sofa and waited and after an hour it went away and I could walk again and went to the party. But I continued to get that pain whenever I did too much walking / physical exertion.
Now, I get this pain when I do too much. This sounds very extreme but I've taken up figure skating. before then, honestly i went nowhere, did nothing and when I did it was a planned day to see a friend and I'd be exhausted after anyway. There was one day I went out with a friend to the nearest city and she had to help me physically get to the train station to get back home because I was struggling to walk and my legs were weak and felt like they were being squeezed to death. My friend was really nice about it though and I really appreciate that she let me lean on her for support.
Figure skating is an intense sport, I know :') but I really really wanted to do it after watching a video of Yuzuru Hanyu skating to Spirited Away's 'One Summers Day'. at first, I got the squeezing pain but it gradually went away over time and I use a heat pack now to help soothe my leg when I get attacks. It kinda feels like my body is physcially stronger but at the same time weak as hell because If i bend down it hurts lol.
At the moment, the worse CFS symptoms are fatigue and brain fog. I did not ever have brain fog when I was first diagnosed and now it feels like I have brain deterioration almost like alzheimer's but not. The fatigue is worse, the best way to describe it is like you're being crushed, it's a crashing fatigue that overwhelms you. When this happens bc of PEM, I am zombified, literally. Does anyone else feel the same? One crash days, It's like *mind empty*, just wandering around the house, half dead, forgetting the words for things - like the word for tea pot - and the fatigue is so intense you are about to cry and you physically cannot talk sometimes? Do you get this too? It feels like it takes physical energy to speak at all and it feels like you are under a matress and don;t have enough energy to force the word "yes" out and when you do it sounds like you are out of breath. On these days, I usually feel like I cannot live so i sleep but this is the WORST thing you can do because then you don't sleep at night and you're even more fatigued but at the same time the fatigue is already so destorying that you cannot stay awake whatsoever so what are you supposed to do when this happens?
Do your parents / family understand CFS too? My mum and dad get angry with me whenever I am zombified. On days where I cannot talk at all because no energy, my mum asks me something and I don't reply so she assumes I'm ignoring her or being difficult. I've tried to explain on better days about how I can't talk but she doesn't understand and she gets mad when I reply with mm because she thinks I'm uninterested. Honestly I feel like they are so sick of me haha. They sometimes bring my tea upstairs because going up stairs makes my legs ache so i do it slowly.
Also I'm going to university this year, no idea how I will live but they'll be free of me!
Anyways, I apologise for this essay lol, thank you so much if you take the time to read all of this! :)

Update 1 - Apr 28 - mid-day US time: Hello all, many thanks for your responses here and also over direct messaging/chat function, I wanted to say I am immensely appreciative of the help parties have reached out to me with, and cannot express my gratitude enough. We are now looking for potentially transferring him at some point in the future to another hospital in Cordoba (Hospital Reina Sofía Córdoba - about an hour drive). But are not entirely sure how this process works - theoretically AIG travel insurance team should be handling this but they are slow here, likely because it is weekend. To be clear, transfer is not me suggesting this hospital or care team is bad or something (goodness, you should see garbage state of medical care in the USA haha. My monthly medications are likely going to exceed his entire hospital bill here) - I am nothing but immensely grateful to them. It is instead the case that he will likely need to be hospitalized for at least another 3 weeks/longer term, and we need someone to consistently be with him in the room and watch him because keeps trying to get out of bed, which he is not supposed to do (due to his low oxygen levels, he is in a state of "delirium" to put it lightly, and this is making a normally sweet natured man argumentative with family and staff) but in Cordoba we have a friend who can help rotate with my family members in watching him. Obviously will not operate against doctors orders if it is the case that he cannot be moved yet (think of this more as question for planning for further future, as he will take him a long time to re-cooperate sufficiently to make it back home to USA), but, if it is appropriate, if anyone here has any suggestions or information on how medical transfers work and/or if that is even allowed in Spain, and how to confirm with receiving hospital in advance that they have spot/bed for a patient and can indeed receive them, then that would be grealty appreciated. In the USA at least, transfers are very common and routine - it is not done to suggest or imply one hospital has bad doctors or building or something, instead (once patient is stabilized and if doctor approves) its usually done to move patient to more convenient location, location that has relevant equipment/medical imaging technology that a more rural facility might lack since some equipment is insanely expensive, etc. My read on the situation may be inaccurate, but it seems doctostaff might be insulted/offended by us asking questions on how transfer works, I assume it may be the case that transfer is less common in spain or maybe it is taken as an insult towards their expertise or something (we are having to work through rough english and spanish translations back and forth as they are not willing/able to speak with paid translators over the phone - it seems the hospital is very busy with lower than normal staff, as it is some major holiday in the area). I realize this situation is ridiculous, and it is classic "american tourist goes to a foreign nation and reinforces every stereotype about Americans" trope (me and my sister tried to stop this trip from happening in first place - we love our parents, but as is obvious, they are very old and not the most competent with technology/accessing patient portal and medical records), so I apologize for my ignorance in this area. Apologies in advance for bothering you all on this board (it seems this board is more about fun topics like vacation in spain), and wanted to again thank you all immensely for your help, and also apologize for typical american ignorance and reinforcing our classic tropes - if they make it back from this trip safe and sound, they will be grounded for foreseeable future haha.
Background: As per the title, my dad is in Spain at the moment and he got infected with COVID-19 and is seriously ill [mid 70s M; 6'2ft; up to date on vaccinations for COVID-19, RSV, flu, etc.; 220 pounds; their condition is active COVID-19, serious breathing trouble, hypoxia, pneumonia, and likely other issues as they are going through ongoing tests right now]
Timeline of Events:

1. My parents’ US doctor prescribed them Paxlovid prior to my dad and mom traveling to Spain. My parents also got the most recent round of COVID-19 boosters for older adults about 4 weeks ago.
   
2. They both tested positive for COVID-19 on Wednesday, April 24 with a molecular Lucira COVID-19 and Flu A/B test, and they both started taking their 5-day course of Paxlovid. They also saw a rural doctor in Spain who prescribed them 5 other medications for my dad to take, as his COVID infection was much more severe than my mom’s. However, I can’t figure out if these medications are worthwhile for COVID-19 and/or if they are contraindicated with Paxlovid since it’s all in Spanish. This includes the following medications: 1. Levofloxcico; 2. Varidasa; 3. Paracetamol; 4. Flutox Jarabe; 5. Vontolin.
   

-After asking on some other Reddit boards and doing some research myself, it seems to be the case that there is no information on any interactions between these drugs and Paxlovid (no information available suggesting there is indeed an interaction or no interactions – so no information either good or bad). However, I assume someone with a medical background might know whether these might be a contraindication risk due to their general drug classes.
-Got in contact with a US based pulmonologist. who suggested that he stop taking varidasa/drug #2, which he did (not sure if this caused things to get better or worse, or if he would have gotten worse regardless), and that he might have hypoxia and thus likely cannot fly/be flown to Madrid or back to US given his current condition (not sure if this meant only airplane travel, or if helicopter travel to Madrid is also barred due to hypoxia).
-Given that my parents just recently got new COVID vaccine boosters + started Paxlovid course immediately after feeling ill and testing positive, I’m not sure why my dad is so sick already (yes he is very old, yes I understand vaccines are not sterilizing, etc.). I have a partial concern that these 5 other random drugs this rural doctor prescribed (now 4 as of this morning), might be making things worse, since Paxlovid is quite harsh on the kidneys/liver, and all these other drugs may be adding no additional health benefit, and instead are just increasing overall toxicity and/or interfering with Paxlovid. Obviously this thought process could just be unconscious bias/seeking something to blame here, and is not rational consideration.

1. My Dad’s condition worsened on Friday April 26, and taken to a small rural hospital in Andújar, Spain (he needed to go to the nearest one ASAP). This is where my mom and dad currently are/where my dad was admitted. My mom is sick with COVID-19 as well but her condition is nowhere near as bad, so she is trying to coordinate things and communicate to me status updates. I believe he is now on oxygen and getting various tests. Pulse oximeter denotes low oxygen levels, and they are running other tests. Confirmed he has pneumonia and are starting IV antibiotics.
   
2. My dad started his 5-day Paxlovid course Wednesday, so he theoretically should be done with it Sunday or Monday – I’m fearing that if he is already in this bad of a state with the added buffer of Paxlovid interfering with viral replication, I can’t imagine what the likely COVID rebound situation will be on Sunday or Monday when he completes the course, and/or whether he can even get an additional package of Paxlovid in Spain (assuming a doctor would recommend that he do that – again, toxicity might be too high as is. Not sure what is liver AST enzymes are at, at the moment).
   

Main Requests
So I guess my ask here is that I am seeking any Spain-based/Spanish Speaking individuals who can advise on:
a. Good pulmonologist (and/or other relevant medical expert) somewhat near Andújar, Spain, or who is in another part of Spain who can help with advice (feel free to DM me if appropriate). Or any recommendation for a good/larger hospital around Andújar, Spain (since they likely can't make it all the way to Madrid which is 4+ hours away where big academic hospitals are).
b. the following medications: 1. Levofloxcico; 2. Varidasa; 3. Paracetamol; 4. Flutox Jarabe; 5. Vontolin. There appears to be no information on whether they interact negatively with Paxlovid. Also, not sure if these medications are good for COVID-19 and/or if there are other medications available in Spain people might recommend, as I'm not sure if Paxlovid is available in Spain or at least this part of Spain. He stopped taking drug # 2./Varidasa as explained above as per telehealth conversation with good pulmonologist in US, but not sure if that is the correct course – obviously doctors know best, but it may be the case that a US doctor would recommend against this medication simply because they don’t know what it is and its unclear if there is a US analog.
Other Requests
c. Any good recommendations on how to go about dealing with Spanish to English language barrier? I only speak English and am based in USA, but it seems all the medical staff at this small hospital speak Spanish only, so not sure how to communicate and coordinate with them, and not sure how to get medical records from US doctors sent to Spain doctors so they can use it. Basically, looking for a doctor, med student, etc. in this area (or some kind of app, paid translation services, etc.) who speaks Spanish and English and who can serve gap between the language barrier here.
d. Any other suggestions on how to handle this situation? Maybe calling US embassy or something? Maybe they can help figure out how to transfer health records from US to Spain, since I assume HIPAA will be an issue? Really not sure what to do.
Concluding Thoughts
Apologies in advance if this breaks any rules and/or is quite an unreasonable ask......not sure what else to do at this stage as I am an ocean away and my passport is expired/I’m stuck in USA (my sister is likely able to get to Spain/where they are in next 48 hours as her passport isn’t expired since she travels a lot – admittedly not sure there is much either of us can do as we are not medical persons).
While my mother is with him and does speak some Spanish, it seems her COVID-19 infection (while not hospitalizing her) is giving her brain fog + making her extremely tired, and so she is having a hard time conversing with parties here.
I love my father and absolutely cannot let him pass like this – if allowed under this subreddit’s rules, I can pay if needed to get help here (and/or donate to charity of ones choosing or something else that is allowable), as I realize this is quite a remote part of Spain and a rather lengthy and complicated ask.
Please help me, I’m desperate and not sure what to do here – this feels like a perfect storm of everything going wrong all at once.

Background: As per the title, my dad is in Spain at the moment and he got infected with COVID-19 and is seriously ill [mid 70s M; 6'2ft; up to date on vaccinations for COVID-19, RSV, flu, etc.; 220 pounds; their condition is active COVID-19, serious breathing trouble, hypoxia, pneumonia, and likely other issues as they are going through ongoing tests right now]
Timeline of Events:

1. My parents’ US doctor prescribed them Paxlovid prior to my dad and mom traveling to Spain. My parents also got the most recent round of COVID-19 boosters for older adults about 4 weeks ago.
   
2. They both tested positive for COVID-19 on Wednesday, April 24 with a molecular Lucira COVID-19 and Flu A/B test, and they both started taking their 5-day course of Paxlovid. They also saw a rural doctor in Spain who prescribed them 5 other medications for my dad to take, as his COVID infection was much more severe than my mom’s. However, I can’t figure out if these medications are worthwhile for COVID-19 and/or if they are contraindicated with Paxlovid since it’s all in Spanish. This includes the following medications: 1. Levofloxcico; 2. Varidasa; 3. Paracetamol; 4. Flutox Jarabe; 5. Vontolin.
   

-After asking on some other Reddit boards and doing some research myself, it seems to be the case that there is no information on any interactions between these drugs and Paxlovid (no information available suggesting there is indeed an interaction or no interactions – so no information either good or bad). However, I assume someone with a medical background might know whether these might be a contraindication risk due to their general drug classes.
-Got in contact with a US based pulmonologist. who suggested that he stop taking varidasa/drug #2, which he did (not sure if this caused things to get better or worse, or if he would have gotten worse regardless), and that he might have hypoxia and thus likely cannot fly/be flown to Madrid or back to US given his current condition (not sure if this meant only airplane travel, or if helicopter travel to Madrid is also barred due to hypoxia).
-Given that my parents just recently got new COVID vaccine boosters + started Paxlovid course immediately after feeling ill and testing positive, I’m not sure why my dad is so sick already (yes he is very old, yes I understand vaccines are not sterilizing, etc.). I have a partial concern that these 5 other random drugs this rural doctor prescribed (now 4 as of this morning), might be making things worse, since Paxlovid is quite harsh on the kidneys/liver, and all these other drugs may be adding no additional health benefit, and instead are just increasing overall toxicity and/or interfering with Paxlovid. Obviously this thought process could just be unconscious bias/seeking something to blame here, and is not rational consideration.

1. My Dad’s condition worsened on Friday April 26, and taken to a small rural hospital in Andújar, Spain (he needed to go to the nearest one ASAP). This is where my mom and dad currently are/where my dad was admitted. My mom is sick with COVID-19 as well but her condition is nowhere near as bad, so she is trying to coordinate things and communicate to me status updates. I believe he is now on oxygen and getting various tests. Pulse oximeter denotes low oxygen levels, and they are running other tests. Confirmed he has pneumonia and are starting IV antibiotics.
   
2. My dad started his 5-day Paxlovid course Wednesday, so he theoretically should be done with it Sunday or Monday – I’m fearing that if he is already in this bad of a state with the added buffer of Paxlovid interfering with viral replication, I can’t imagine what the likely COVID rebound situation will be on Sunday or Monday when he completes the course, and/or whether he can even get an additional package of Paxlovid in Spain (assuming a doctor would recommend that he do that – again, toxicity might be too high as is. Not sure what is liver AST enzymes are at, at the moment).
   

Main Requests
So I guess my ask here is that I am seeking any Spain-based/Spanish Speaking individuals who can advise on:
a. Good pulmonologist (and/or other relevant medical expert) somewhat near Andújar, Spain, or who is in another part of Spain who can help with advice (feel free to DM me if appropriate). Or any recommendation for a good/larger hospital around Andújar, Spain (since they likely can't make it all the way to Madrid which is 4+ hours away where big academic hospitals are).
b. the following medications: 1. Levofloxcico; 2. Varidasa; 3. Paracetamol; 4. Flutox Jarabe; 5. Vontolin. There appears to be no information on whether they interact negatively with Paxlovid. Also, not sure if these medications are good for COVID-19 and/or if there are other medications available in Spain people might recommend, as I'm not sure if Paxlovid is available in Spain or at least this part of Spain. He stopped taking drug # 2./Varidasa as explained above as per telehealth conversation with good pulmonologist in US, but not sure if that is the correct course – obviously doctors know best, but it may be the case that a US doctor would recommend against this medication simply because they don’t know what it is and its unclear if there is a US analog.
Other Requests
c. Any good recommendations on how to go about dealing with Spanish to English language barrier? I only speak English and am based in USA, but it seems all the medical staff at this small hospital speak Spanish only, so not sure how to communicate and coordinate with them, and not sure how to get medical records from US doctors sent to Spain doctors so they can use it. Basically, looking for a doctor, med student, etc. in this area (or some kind of app, paid translation services, etc.) who speaks Spanish and English and who can serve gap between the language barrier here.
d. Any other suggestions on how to handle this situation? Maybe calling US embassy or something? Maybe they can help figure out how to transfer health records from US to Spain, since I assume HIPAA will be an issue? Really not sure what to do.
Concluding Thoughts
Apologies in advance if this breaks any rules and/or is quite an unreasonable ask......not sure what else to do at this stage as I am an ocean away and my passport is expired/I’m stuck in USA (my sister is likely able to get to Spain/where they are in next 48 hours as her passport isn’t expired since she travels a lot – admittedly not sure there is much either of us can do as we are not medical persons).
While my mother is with him and does speak some Spanish, it seems her COVID-19 infection (while not hospitalizing her) is giving her brain fog + making her extremely tired, and so she is having a hard time conversing with parties here.
I love my father and absolutely cannot let him pass like this – if allowed under this subreddit’s rules, I can pay if needed to get help here (and/or donate to charity of ones choosing or something else that is allowable), as I realize this is quite a remote part of Spain and a rather lengthy and complicated ask.
Please help me, I’m desperate and not sure what to do here – this feels like a perfect storm of everything going wrong all at once.

NOTE: This post is not seeking direct medical advice/answers to the medical questions in of themselves. Instead, this post is moreso directed at whether anyone has any recommendations on what I should do and/or direction to any resources that might help answer these questions (i.e., how do I find good pulmonologist who speaks english and Spanish, as I dont speak Spanish). Honestly, I realize my efforts to do anything here might be futile, so seeing if anyone has had a similiar experience and how they dealt with it emotionally or otherwise.
​
Background: As per the title, my dad is in Spain at the moment and he got infected with COVID-19 and is seriously ill [mid 70s M; 6'2ft; up to date on vaccinations for COVID-19, RSV, flu, etc.; 220 pounds; their condition is active COVID-19, serious breathing trouble, hypoxia, pneumonia, and likely other issues as they are going through ongoing tests right now]
Timeline of Events:
1.My parents’ US doctor prescribed them Paxlovid prior to my dad and mom traveling to Spain. My parents also got the most recent round of COVID-19 boosters for older adults about 4 weeks ago.

1. They both tested positive for COVID-19 on Wednesday, April 24 with a molecular Lucira COVID-19 and Flu A/B test, and they both started taking their 5-day course of Paxlovid. They also saw a rural doctor in Spain who prescribed them 5 other medications for my dad to take, as his COVID infection was much more severe than my mom’s. However, I can’t figure out if these medications are worthwhile for COVID-19 and/or if they are contraindicated with Paxlovid since it’s all in Spanish. This includes the following medications: 1. Levofloxcico; 2. Varidasa; 3. Paracetamol; 4. Flutox Jarabe; 5. Vontolin.

-After asking on some other Reddit boards and doing some research myself, it seems to be the case that there is no information on any interactions between these drugs and Paxlovid (no information available suggesting there is indeed an interaction or no interactions – so no information either good or bad). However, I assume someone with a medical background might know whether these might be a contraindication risk due to their general drug classes.
-Got in contact with a US based pulmonologist. who suggested that he stop taking varidasa/drug #2, which he did (not sure if this caused things to get better or worse, or if he would have gotten worse regardless), and that he might have hypoxia and thus likely cannot fly/be flown to Madrid or back to US given his current condition (not sure if this meant only airplane travel, or if helicopter travel to Madrid is also barred due to hypoxia).
-Given that my parents just recently got new COVID vaccine boosters + started Paxlovid course immediately after feeling ill and testing positive, I’m not sure why my dad is so sick already (yes he is very old, yes I understand vaccines are not sterilizing, etc.). I have a partial concern that these 5 other random drugs this rural doctor prescribed (now 4 as of this morning), might be making things worse, since Paxlovid is quite harsh on the kidneys/liver, and all these other drugs may be adding no additional health benefit, and instead are just increasing overall toxicity and/or interfering with Paxlovid. Obviously this thought process could just be unconscious bias/seeking something to blame here, and is not rational consideration.

1. My Dad’s condition worsened on Friday April 26, and taken to a small rural hospital in Andújar, Spain (he needed to go to the nearest one ASAP). This is where my mom and dad currently are/where my dad was admitted. My mom is sick with COVID-19 as well but her condition is nowhere near as bad, so she is trying to coordinate things and communicate to me status updates. I believe he is now on oxygen and getting various tests. Pulse oximeter denotes low oxygen levels, and they are running other tests. Confirmed he has pneumonia and are starting IV antibiotics.
   
2. My dad started his 5-day Paxlovid course Wednesday, so he theoretically should be done with it Sunday or Monday – I’m fearing that if he is already in this bad of a state with the added buffer of Paxlovid interfering with viral replication, I can’t imagine what the likely COVID rebound situation will be on Sunday or Monday when he completes the course, and/or whether he can even get an additional package of Paxlovid in Spain (assuming a doctor would recommend that he do that – again, toxicity might be too high as is. Not sure what is liver AST enzymes are at, at the moment).
   

Main Requests
So I guess my ask here is that I am seeking any Spain-based/Spanish Speaking individuals who can advise on:
a. Good pulmonologist (and/or other relevant medical expert) somewhat near Andújar, Spain, or who is in another part of Spain who can help with advice (feel free to DM me if appropriate). Or any recommendation for a good/larger hospital around Andújar, Spain (since they likely can't make it all the way to Madrid which is 4+ hours away where big academic hospitals are).
b. the following medications: 1. Levofloxcico; 2. Varidasa; 3. Paracetamol; 4. Flutox Jarabe; 5. Vontolin. There appears to be no information on whether they interact negatively with Paxlovid. Also, not sure if these medications are good for COVID-19 and/or if there are other medications available in Spain people might recommend, as I'm not sure if Paxlovid is available in Spain or at least this part of Spain. He stopped taking drug # 2./Varidasa as explained above as per telehealth conversation with good pulmonologist in US, but not sure if that is the correct course – obviously doctors know best, but it may be the case that a US doctor would recommend against this medication simply because they don’t know what it is and its unclear if there is a US analog.
Other Requests
c. Any good recommendations on how to go about dealing with Spanish to English language barrier? I only speak English and am based in USA, but it seems all the medical staff at this small hospital speak Spanish only, so not sure how to communicate and coordinate with them, and not sure how to get medical records from US doctors sent to Spain doctors so they can use it. Basically, looking for a doctor, med student, etc. in this area (or some kind of app, paid translation services, etc.) who speaks Spanish and English and who can serve gap between the language barrier here.
d. Any other suggestions on how to handle this situation? Maybe calling US embassy or something? Maybe they can help figure out how to transfer health records from US to Spain, since I assume HIPAA will be an issue? Really not sure what to do.
Concluding Thoughts
Apologies in advance if this breaks any rules and/or is quite an unreasonable ask......not sure what else to do at this stage as I am an ocean away and my passport is expired/I’m stuck in USA (my sister is likely able to get to Spain/where they are in next 48 hours as her passport isn’t expired since she travels a lot – admittedly not sure there is much either of us can do as we are not medical persons).
While my mother is with him and does speak some Spanish, it seems her COVID-19 infection (while not hospitalizing her) is giving her brain fog + making her extremely tired, and so she is having a hard time conversing with parties here.
I love my father and absolutely cannot let him pass like this – if allowed under this subreddit’s rules, I can pay if needed to get help here (and/or donate to charity of ones choosing or something else that is allowable), as I realize this is quite a remote part of Spain and a rather lengthy and complicated ask.
Please help me, I’m desperate and not sure what to do here – this feels like a perfect storm of everything going wrong all at once.

Background: As per the title, my dad is in Spain at the moment and he got infected with COVID-19 and is seriously ill [mid 70s M; 6'2ft; up to date on vaccinations for COVID-19, RSV, flu, etc.; 220 pounds; their condition is active COVID-19, serious breathing trouble, hypoxia, pneumonia, and likely other issues as they are going through ongoing tests right now]
Timeline of Events:

1. My parents’ US doctor prescribed them Paxlovid prior to my dad and mom traveling to Spain. My parents also got the most recent round of COVID-19 boosters for older adults about 4 weeks ago.
   
2. They both tested positive for COVID-19 on Wednesday, April 24 with a molecular Lucira COVID-19 and Flu A/B test, and they both started taking their 5-day course of Paxlovid. They also saw a rural doctor in Spain who prescribed them 5 other medications for my dad to take, as his COVID infection was much more severe than my mom’s. However, I can’t figure out if these medications are worthwhile for COVID-19 and/or if they are contraindicated with Paxlovid since it’s all in Spanish. This includes the following medications: 1. Levofloxcico; 2. Varidasa; 3. Paracetamol; 4. Flutox Jarabe; 5. Vontolin.
   

-After asking on some other Reddit boards and doing some research myself, it seems to be the case that there is no information on any interactions between these drugs and Paxlovid (no information available suggesting there is indeed an interaction or no interactions – so no information either good or bad). However, I assume someone with a medical background might know whether these might be a contraindication risk due to their general drug classes.
-Got in contact with a US based pulmonologist. who suggested that he stop taking varidasa/drug #2, which he did (not sure if this caused things to get better or worse, or if he would have gotten worse regardless), and that he might have hypoxia and thus likely cannot fly/be flown to Madrid or back to US given his current condition (not sure if this meant only airplane travel, or if helicopter travel to Madrid is also barred due to hypoxia).
-Given that my parents just recently got new COVID vaccine boosters + started Paxlovid course immediately after feeling ill and testing positive, I’m not sure why my dad is so sick already (yes he is very old, yes I understand vaccines are not sterilizing, etc.). I have a partial concern that these 5 other random drugs this rural doctor prescribed (now 4 as of this morning), might be making things worse, since Paxlovid is quite harsh on the kidneys/liver, and all these other drugs may be adding no additional health benefit, and instead are just increasing overall toxicity and/or interfering with Paxlovid. Obviously this thought process could just be unconscious bias/seeking something to blame here, and is not rational consideration.

1. My Dad’s condition worsened on Friday April 26, and taken to a small rural hospital in Andújar, Spain (he needed to go to the nearest one ASAP). This is where my mom and dad currently are/where my dad was admitted. My mom is sick with COVID-19 as well but her condition is nowhere near as bad, so she is trying to coordinate things and communicate to me status updates. I believe he is now on oxygen and getting various tests. Pulse oximeter denotes low oxygen levels, and they are running other tests. Confirmed he has pneumonia and are starting IV antibiotics.
   
2. My dad started his 5-day Paxlovid course Wednesday, so he theoretically should be done with it Sunday or Monday – I’m fearing that if he is already in this bad of a state with the added buffer of Paxlovid interfering with viral replication, I can’t imagine what the likely COVID rebound situation will be on Sunday or Monday when he completes the course, and/or whether he can even get an additional package of Paxlovid in Spain (assuming a doctor would recommend that he do that – again, toxicity might be too high as is. Not sure what is liver AST enzymes are at, at the moment).
   

Main Requests
So I guess my ask here is that I am seeking any Spain-based/Spanish Speaking individuals who can advise on:
a. Good pulmonologist (and/or other relevant medical expert) somewhat near Andújar, Spain, or who is in another part of Spain who can help with advice (feel free to DM me if appropriate). Or any recommendation for a good/larger hospital around Andújar, Spain (since they likely can't make it all the way to Madrid which is 4+ hours away where big academic hospitals are).
b. the following medications: 1. Levofloxcico; 2. Varidasa; 3. Paracetamol; 4. Flutox Jarabe; 5. Vontolin. There appears to be no information on whether they interact negatively with Paxlovid. Also, not sure if these medications are good for COVID-19 and/or if there are other medications available in Spain people might recommend, as I'm not sure if Paxlovid is available in Spain or at least this part of Spain. He stopped taking drug # 2./Varidasa as explained above as per telehealth conversation with good pulmonologist in US, but not sure if that is the correct course – obviously doctors know best, but it may be the case that a US doctor would recommend against this medication simply because they don’t know what it is and its unclear if there is a US analog.
Other Requests
c. Any good recommendations on how to go about dealing with Spanish to English language barrier? I only speak English and am based in USA, but it seems all the medical staff at this small hospital speak Spanish only, so not sure how to communicate and coordinate with them, and not sure how to get medical records from US doctors sent to Spain doctors so they can use it. Basically, looking for a doctor, med student, etc. in this area (or some kind of app, paid translation services, etc.) who speaks Spanish and English and who can serve gap between the language barrier here.
d. Any other suggestions on how to handle this situation? Maybe calling US embassy or something? Maybe they can help figure out how to transfer health records from US to Spain, since I assume HIPAA will be an issue? Really not sure what to do.
Concluding Thoughts
Apologies in advance if this breaks any rules and/or is quite an unreasonable ask......not sure what else to do at this stage as I am an ocean away and my passport is expired/I’m stuck in USA (my sister is likely able to get to Spain/where they are in next 48 hours as her passport isn’t expired since she travels a lot – admittedly not sure there is much either of us can do as we are not medical persons).
While my mother is with him and does speak some Spanish, it seems her COVID-19 infection (while not hospitalizing her) is giving her brain fog + making her extremely tired, and so she is having a hard time conversing with parties here.
I love my father and absolutely cannot let him pass like this – if allowed under this subreddit’s rules, I can pay if needed to get help here (and/or donate to charity of ones choosing or something else that is allowable), as I realize this is quite a remote part of Spain and a rather lengthy and complicated ask.
Please help me, I’m desperate and not sure what to do here – this feels like a perfect storm of everything going wrong all at once.

In April of last year I woke up with right lower back/hip pain and I brushed it off as just symptom of sleeping in an awkward position or potentially strained muscle from increased exercise the previous day but here I am a year later still in pain and getting progressively worse.
There's just this dull radiating aching, burning/scratching sensation that will not go away and while constant, the level of pain from 3 or 4 to 5 or 6 (sometimes worse on a bad day) is completely unpredictable it does not corrilate with increased rest or exercise or time of day and it's honestly driving me crazy because typical pain medication like paracetamol and ibuprofen do next to nothing.
Sitting for too long hurts Standing for too long hurts Walking, stretching, exercise, anything I do for an extended period of time just hurts.
I've been referred to a psychologist and psychiatrist because my doctor can not find the cause of my pain and one of the only options left Is psychosomatic and honestly at this point I don't care if it's all in my head I just care about figuring out what I can do to fix or even just manage the pain.
What can I do?
What coping mechanisms can I use to deal with nagging pain?
What other causes or concerns should I bring up to my doctophysio/future psychologist?
I just want to make sure I'm not missing anything that could help me understand and manage my pain I'm a week and a half away from turning 20 I'm young all my tests say I'm healthy I have so much of my life still ahead of me yet I'm at a point where I have no clue how to effectively enjoy my life in my current state of chronic pain.

This is not intended to be medical advice, this is me sharing my journey and how I came to some major conclusions about what caused such a severe systemic candida overgrowth, because reading other people’s experiences helped me discover this.
I’ll leave some info on what I actually eat in a day - finding out what to eat was the HARDEST part of this so I want to leave some hope.
This is not forever, but we need to give our bodies the best shot at healing.
Before you start ANY candida killing protocol - I would make sure of the following:

1. Passing stool at least once a day
2. Urinating regularly
3. Sweating regularly in controlled scenarios and able to wash the sweat OFF after
4. Magnesium sulfate (epsom salt) baths regularly to detox through skin
5. Consuming zero gluten
6. Zero refined grains - rice, oats etc.
7. Consuming zero dairy for a month
8. Increase fibre: leafy greens, avoid excess dark leafy greens as they’re high in oxalates
9. Supporting the liver with herbal teas: dandelion root, milk thistle seed, calendula, peppermint, fennel
10. Zero seed oils: use avocado, olive or coconut
11. Zero processed food for the first two weeks - a month other than occasional peanut butter / almond butter, almond milk and coconut milk.
12. Check all products if they contain tapioca starch / maltodextrin - this raises your blood sugar.
13. Avoid protein powder, this raises your insulin resistance (while it might not raise glucose, it does contribute to insulin instability)
14. No fruit for the first two weeks - slowly reintroduce low carb fruit like blueberries, blackcurrants, blackberry
15. Reduce toxic load: Aluminum from cookware; fragrances; harsh cleaning chemicals; soaps and beauty products; oxalates - spinach; phytic acid - nuts and seeds that haven’t been activated; lectins - legumes. A normal healthy person will have no issue digesting and breaking these down - you will. Your liver is already working so hard, take some pressure off.
16. Find a way to regulate your nervous system EVERY DAY: vagal nerve exercises, somatic exercise, walking with intention, go to the beach, ground your feet in the earth, hug a tree, listen to bird song, breathing exercises, yoga, qigong, taichi, tapping, something.
17. Limit phone usage after sunset, switch to orange warm lighting after sunset.
18. Get outside, sun on your face as early in the morning as you can for at least 15 minutes, no sunglasses
19. Oil pulling daily first thing in the morning - if oral candida is present this habit is absolutely necessary
20. Consider supplementing Vitamin D3 + K2, up to 3000 IU per day
21. If you’re still working, consider reducing your hours or taking some time off. I know money is important, but so is your health. How are you going to earn sustainably if you’re constantly taking time off for illness?
22. Consider finding a local naturopathic or functional medicine doctor - I wish I had done this earlier.

If you are experiencing strong herx reactions, STOP any antifungals or even herbal supplements for 1-2 months because your detox pathways are NOT open and flowing - so all the toxicity from the dead and alive candida is getting stuck in your system.
Focus on detoxification, and getting the same active ingredients in your diet and herbal tea instead! Garlic, ginger, oregano, thyme - that doesn’t sound like a good tea but it slaps as seasoning for chicken meat stock. Caprylic acid is found in coconut oil!
Why are the candida here? This took me ages to figure out… Adrenal fatigue, a struggling immune system and trouble eliminating waste.

1. SSRIs, ADHD medication all raise blood sugar and lead to adrenal fatigue
2. Excessive use of antihistamines and topical steroids suppress the immune system and lead to adrenal fatigue
3. High carb, high processed diet lead to uncontrolled blood sugar, insulin resistance
4. Dysregulated nervous system leads to prolonged stress, leads to nutrient deficiency over time
5. Poor detoxification pathways due to lifestyle mentioned above, also a potential genetic component of MTHFR genes - not confirmed as I’m waiting on testing but I observe poor detoxification in all family members on my mother’s side.
6. Poor immune system function due to lifestyle mentioned above, lymph nodes were hard and backed up
7. Struggling liver despite not consuming alcohol, it was overloaded with detoxification requirements, my eyes started to turn yellow
8. Gut dysbiosis. I had far too many antibiotics in my life. I have discovered herbal and extract remedies that can get rid of incoming strep throat. Support the immune system and detox pathways, rest, and your body will do the work.
9. Mercury and aluminum, I found through HTMA testing my body was eliminating some heavy metals. I switched to stainless steel cookware, aluminum free deodorant. I don’t even use deodorant most days now.
10. Issue with methylation due to lifestyle mentioned above, potential genetic component. Changing your diet and lifestyle can support proper methylation of chemicals in your body, I achieved this naturally with melatonin regulation! I don’t need to take it anymore.

Testing I had done:

• HTMA - this gives you a snapshot of what your body is / isn’t eliminating at present. It’s what prompted me to self-diagnose with adrenal fatigue because I displayed minimal amounts of sodium and potassium despite my blood tests showing normal amounts. I wasn’t absorbing them due to gut dysbiosis. It’s also how I found out I have 0 lithium, I take 25mg lithium so I could get off my ADHD medication. It’s not a necessary test but it can be helpful - and get you a script for lithium if you need it.
• Full liver panel - I had low GGT, not quite liver disease but it did mean my liver was slow (yellowing eyes, cloudy vision)
• Zinc (plasma) - still waiting on test results
• Homocysteine - still waiting on results
• Early morning histamine - still waiting on results

Why no testing for candida?
It’s hard to test for, it’s expensive. I didn’t need a test. I’d had yeast infections for years. It was in my vagina, the corners of my mouth, my hand, my toe, my gut. I had such an intense craving for sugar and carbs, partly due to insulin resistance, but I would get very moody and upset without them. This is the candida screaming, not you, you have to have the willpower to go low carb for 2 weeks to get through this. I don’t crave or miss refined carbohydrates anymore... okay I get a little when I'm on my third 'kill protocol' day (at end of post).
How did I know it's not SIBO or something else? After I nailed the diet for two weeks, cut out refined and starchy carbohydrates - any bloating I had went away. It was never that bad in the first place for me personally.
What did I eat in my elimination period?

• Fresh vegetables: avocado (watch out if you have histamine intolerance 😭), leafy greens, butternut squash, broccoli, brussel sprouts, cauliflower, radish, cucumber, celery, rocket/arugla, bok choy
• Flavour: White onion, red onion (I literally have it with every meal now), garlic
• Spices: Oregano, thyme, basil, sage, salt, pepper, fennel, turmeric,
• Meats: Chicken meat stock (not bone broth), chicken soup (meat stock + chicken thigh)
• Oils: coconut, extra virgin olive, avocado (high histamine)
• “Snacks” Keto bread; almond butter; occasional peanut butter; smoothies with blueberry, blackcurrant, blackberries, almond milk; activated and then dehydrated or roasted nuts and seeds; keto seed crackers with no additives or preservatives
• Two hard boiled eggs a day with breakfast (best B vitamin out there)

What do I eat now?

• All of the above, I'll be honest I'm scared to try new foods again but I know I'll need to start pushing myself to do so.
• I’m putting a few more berries into my smoothie
• Carrot sticks
• Apples, I am experimenting with one a day 30 minutes before a meal or two hours after (fruit digests really fast, so we want it to get through the small intestine really quickly, other food such as fats can slow down digestion in the upper intestines and lead to more sugar released into the system than we want)
• Red meat 3 times a week
• Occasional dairy at minimal amounts

Where’s your fermented food and cabbage?!

• I have histamine intolerance, so unfortunately I can’t have these, I’ve had to restore my microbiome slower with the cruciferous veggies and a probiotic. I would still recommend avoiding them for your two week elimination period, just to make sure and give your body a break.

Probiotics:

• Clinicians Flora Restore contains Lactobacillus rhamnosus and Lactobacillus reuteri
• Mutaflor: contains non-pathogenic strain Escherichia coli Nissle 1917 (EcN) - if you’re not pooping I HIGHLY recommend this, yes it’s expensive but if you do at least 50 capsules worth you’ll feel so much better. If you do not take any antibiotics after taking this they will continue to repopulate your system.

The kill protocol:
THIS IS A SLOW BURN. If you come in hot and heavy trying to kill every last one of these suckers you will be the sucker. You can’t eradicate all candida, we actually need some for digestion, we’re just trying to remove the overgrowth and encourage a more diverse microbiome through diet.

• Stay on your elimination diet for 2-4 weeks until things start to calm down, slowly turn up the herbs in your diet, you’ll be surprised how much you can enjoy orally once your sugar cravings are gone.
• Find a supplement that contains oregano extract, sodium caprylate (caprylic acid), ginger, turmeric extract, olive extract. Do your research, read reviews, watch out for additives.
• I like Candicial by xymogen as it’s a relatively low serving.
• For Candicial start with one capsule with food for 3 days, and then take a 3 day break.
• If you feel similar to before you started the diet, I’m sorry but that means it’s working. Go hard on the detox support; Hyperbaric oxygen chamber therapy, manual oxygenation with breathwork, epsom salt bath, increase water intake, herbal tea, warm showers, sauna, walking.
• Make sure you’re taking a probiotic in the evening before bed, two hours away from the supplement.
• If you get: pimples, rashes on the backs of your hands or other places, fatigue, muscle or joint aches and pains, flu like symptoms - these are all normal and that’s why we take a 3 day break. To give our body a chance to catch up to the detoxification it has to do.
• Use distractions, spend time with friends and family,
• Keep going with 3 days on, 3 days off, at one pill until symptoms subside or are at least tolerable, then increase to the full dosage (for Candicial that’s two pills) until you get to that stage where symptoms have subsided again
• Sometimes we’re worse at detoxing, especially when we’re stressed - you might need to dial it back to one pill sometimes and that’s okay

Why no NAC:

• For severe and systemic candida like myself, it's best to wait until symptoms are well under control before starting NAC. This is under the advisement of my naturopathic doctor.

I'm a slow detoxer, slow methylator, adrenal fatigue, slow liver, my body doesn't have the strength or resources to handle how strong NAC can be.
Emergency detox:

• For severe symptoms that aren’t decreasing after eating or drinking, you could take 1-2 activated charcoal pills. This will dehydrate you, so drink lots of water. It binds to EVERYTHING, so if you have any life saving medication please be aware. Best taken 2 hours before or after food and medication, because it will bind to it all and you’ll eliminate it. I do not recommend this for daily use, try to focus on the other detoxification pathways instead: urine, poop, sweat, liver.

I 17M have been experiencing multiple symptoms roughly starting back in covid time and they have progressively worsened.
SYMPTOMS:
The worst symptom I have is a never ending headache. The pain never completely goes away however it does get worse. The pain is hard to describe but i will try. The pain starts where the head and neck connect and wraps around the top of my head to my forehead(almost feels like it is in my skin). The pain is like electric/fire and if i touch my scalp even slightly my head will hurt immensely where i touched it. Also there feels as if there is a general pressure within my head which accompanies the scalp pain. The pain gets worse if i stand up or keep a very straight back for 10-20 minutes and becomes unbearable. Some days i just lay in bed because it makes it slightly better.
something that seems to be directly related to the headaches is pretty constant vertigo that is pretty bearable when sitting or laying down however if i stand up for too long it can start to feel like the world is spinning a bit. i thought that it could be related to blood not getting to my head but my heart rate doesn't seem to get much higher and my blood pressure seems to be fine when standing/sitting.
i also experience eye pain that feels like it is behind my eye this isn't intensified when i stand up like the headache and vertigo and isn't always there (seemingly more in the morning when i wake up). Hurts more if i try to move my eyes.
Another thing i experience is visual snow which is a condition where you see TV static overlaying your vision.This also never goes away however i believe that it doesn't really change in intensity. i struggle to read and it is very difficult during college. the vision has caused me to be very night blind as when it gets dark enough i am pretty much blind. this simulator is simular to what it is like. https://visionsimulations.com/visual-snow.htm?background=night1.jpg . This symptom is so disruptive and i would probably say it is the second worst thing i experience beaten by the head pain.
i also have ringing in my ears which i dont mind too much as it is nothing compared to the pain and vision however it is a consistent high pitched note that is noticable in quieter places which can be very annoying sometimes.
i also seem to have constant neck stiffness as if it try to move my neck at all it feels sore and slightly painful. this extends a little bit to my upper back. have been seeing a physiotherapist a few times over the course of a few months but hasn't helped one bit or made it worse.
should probably mention that my heart rate is quite high normally like 90-110 even when sitting down a while or doing anything. does not increase significantly if i stand up.
i for some reason have lots of tremors and twitching muscles throughout my entire body where many times throughout the day a random muscle will start spasming for a minute and then stop.
dont really think that it is relevant but i'll mention that i have been depressed for as long as i have experienced these symptoms and i want to make it clear that the depression is a symptom of the problems and these problems are not a symptom of the depression. haven't had this treated but honestly dont think there is any need to as i believe that as long as i have these symptoms i will be miserable.
another issue is that i really struggle with sleep and its really disruptive with my life. i believe the reason i cannot sleep is due to the pain and if the pain is gone then sleeping would be easy but i cannot be sure as i can never escape the pain. i can lay in bed at night and not fall asleep at all for like 6 hours(pretty usual) however as soon as i get to sleep i have no problem staying asleep.
i feel generally tired most days however i am very hesitant to say this is a symptom and not just due to the depression and the atrocious sleep schedule however the fact that i can sleep for 12 hours for weeks and still feel tired makes me think possibly something else is at play.
another problem i seem to have is generally poor memory and concentration. i dont think this is due to the pain even though it can be debilitating as i will so often forget what i was doing or struggle to find the word i was looking for and this is really stressing me out as i sometimes just dont feel like myself at all.
finally i will say that all these issues have gotten slightly worse over time i believe and not all of them were present at the start.
MEDICAL CHECKS AND MEDICATION:
i have had a brain MRI 2022 and a cervical spine MRI 2023 which both came back as normal according to neurology.
i have had a full blood count which was unremarkable apart from low but not deficient b12 which i have now been taking supplements for(couple months now) (haven't noticed a difference).
neurologist wants to check my head again with another mri. dont have a date yet.
seen neuro opthamologist several times and had eyes checked with like a million different machines all coming back normal.
i have taken pizotifen and amitriptyline which were taken separately and i honestly didn't feel any different (took them both for a couple months i think).
also paracetamol and ibuprofen dont seem to help the pain at all.
currently sometimes use codeine as it does help the pain slightly but makes me lethargic which helps sleep a bit but i need to be as awake as possible usually so dont like to rely on it.
am being referred to pain management and headache clinic however i really just want to find the cause of the problems as i feel like if we find that then we can figure out how to fix it.
CONCLUSION:
thank you if you read this far i can tell you that this was a pain to write as reading is SOOO annoying so there are probably so many spelling mistakes. i would really appreciate any help or suggestions as to what could be causing all this as i am so fed up of this as i feel like my life has been destroyed and all i want to is get it back.
a question i do have is could this be related to csf leak? because from what i have read if you stand up it can cause a worsening of headache however it also says when you sit up which isn't always the case for me
another question is could this be POTS? however that says that if you stand up your heart rate must increase by 30 which isn't the case for me.

first time using reddit so hopefully this all goes well
I 17M have been experiencing multiple symptoms roughly starting back in covid time and they have progressively worsened.
SYMPTOMS:
The worst symptom I have is a never ending headache. The pain never completely goes away however it does get worse. The pain is hard to describe but i will try. The pain starts where the head and neck connect and wraps around the top of my head to my forehead(almost feels like it is in my skin). The pain is like electric/fire and if i touch my scalp even slightly my head will hurt immensely where i touched it. Also there feels as if there is a general pressure within my head which accompanies the scalp pain. The pain gets worse if i stand up or keep a very straight back for 10-20 minutes and becomes unbearable. Some days i just lay in bed because it makes it slightly better.
something that seems to be directly related to the headaches is pretty constant vertigo that is pretty bearable when sitting or laying down however if i stand up for too long it can start to feel like the world is spinning a bit. i thought that it could be related to blood not getting to my head but my heart rate doesn't seem to get much higher and my blood pressure seems to be fine when standing/sitting.
i also experience eye pain that feels like it is behind my eye this isn't intensified when i stand up like the headache and vertigo and isn't always there (seemingly more in the morning when i wake up). Hurts more if i try to move my eyes.
Another thing i experience is visual snow which is a condition where you see TV static overlaying your vision.This also never goes away however i believe that it doesn't really change in intensity. i struggle to read and it is very difficult during college. the vision has caused me to be very night blind as when it gets dark enough i am pretty much blind. this simulator is simular to what it is like. https://visionsimulations.com/visual-snow.htm?background=night1.jpg . This symptom is so disruptive and i would probably say it is the second worst thing i experience beaten by the head pain.
i also have ringing in my ears which i dont mind too much as it is nothing compared to the pain and vision however it is a consistent high pitched note that is noticable in quieter places which can be very annoying sometimes.
i also seem to have constant neck stiffness as if it try to move my neck at all it feels sore and slightly painful. this extends a little bit to my upper back. have been seeing a physiotherapist a few times over the course of a few months but hasn't helped one bit or made it worse.
should probably mention that my heart rate is quite high normally like 90-110 even when sitting down a while or doing anything. does not increase significantly if i stand up.
i for some reason have lots of tremors and twitching muscles throughout my entire body where many times throughout the day a random muscle will start spasming for a minute and then stop.
dont really think that it is relevant but i'll mention that i have been depressed for as long as i have experienced these symptoms and i want to make it clear that the depression is a symptom of the problems and these problems are not a symptom of the depression. haven't had this treated but honestly dont think there is any need to as i believe that as long as i have these symptoms i will be miserable.
another issue is that i really struggle with sleep and its really disruptive with my life. i believe the reason i cannot sleep is due to the pain and if the pain is gone then sleeping would be easy but i cannot be sure as i can never escape the pain. i can lay in bed at night and not fall asleep at all for like 6 hours(pretty usual) however as soon as i get to sleep i have no problem staying asleep.
i feel generally tired most days however i am very hesitant to say this is a symptom and not just due to the depression and the atrocious sleep schedule however the fact that i can sleep for 12 hours for weeks and still feel tired makes me think possibly something else is at play.
another problem i seem to have is generally poor memory and concentration. i dont think this is due to the pain even though it can be debilitating as i will so often forget what i was doing or struggle to find the word i was looking for and this is really stressing me out as i sometimes just dont feel like myself at all.
finally i will say that all these issues have gotten slightly worse over time i believe and not all of them were present at the start.
MEDICAL CHECKS AND MEDICATION:
i have had a brain MRI 2022 and a cervical spine MRI 2023 which both came back as normal according to neurology.
i have had a full blood count which was unremarkable apart from low but not deficient b12 which i have now been taking supplements for(couple months now) (haven't noticed a difference).
neurologist wants to check my head again with another mri. dont have a date yet.
seen neuro opthamologist several times and had eyes checked with like a million different machines all coming back normal.
i have taken pizotifen and amitriptyline which were taken separately and i honestly didn't feel any different (took them both for a couple months i think).
also paracetamol and ibuprofen dont seem to help the pain at all.
currently sometimes use codeine as it does help the pain slightly but makes me lethargic which helps sleep a bit but i need to be as awake as possible usually so dont like to rely on it.
am being referred to pain management and headache clinic however i really just want to find the cause of the problems as i feel like if we find that then we can figure out how to fix it.
CONCLUSION:
thank you if you read this far i can tell you that this was a pain to write as reading is SOOO annoying so there are probably so many spelling mistakes. i would really appreciate any help or suggestions as to what could be causing all this as i am so fed up of this as i feel like my life has been destroyed and all i want to is get it back.
a question i do have is could this be related to csf leak? because from what i have read if you stand up it can cause a worsening of headache however it also says when you sit up which isn't always the case for me
another question is could this be POTS? however that says that if you stand up your heart rate must increase by 30 which isn't the case for me.

I'm 37, been weight lifting for about 16 years. For about 6-7 years I have followed a bodybuilder diet building my weight up to the highest of 256lbs and still had abs at 5'9. I of course had cheat meals and large amounts of it when I did, sometimes going a little overboard, more on that shortly.
When I got to around 35, I took a step back from bodybuilding to have a more rounded life, enjoy food and not worrying so much about regimented diets. I still go to the gym 4-5 times a week and train hard. I only eat 3-4 meals a day, low calorie, high proteins to keep some muscle mass, but we were having takeaways at least 1-2 times a week.
Due to being able to eat so much from bodybuilding, I could put a serious amount of food away, I still don't drink.
An average delivery from papa John's for me would be an XXL stuffed crust meat pizza which I'd leave about 2 slices of, bacon cheese sticks side, which I'd eat all of and probably a cookie or brownie tray which I'd share with my girlfriend. Then later in the week we might get a takeaway burger and chips, kebab, or sushi. And I learnt to bake, and got quite good at it! So I was often making cakes, cookies, brownies etc and with just two of us to eat it all, you can imagine the amount of sugar we were having!
I certainly put on a bit of fat, my lower stomach mainly, but you could still see my abs a little and weight was hovering around 240lbs.
I keep an eye on my blood work a few times a year, as I am also on TRT. I noticed over the last year or so, my ALT and GGT was creeping up. Highest ALT - 90, GGT - 75. Blood tests were usually a day of rest before or otherwise for the most part I would have trained the day before, so ALT is raised a bit, just not that high.
Latest blood results were - ALT - 72 U/L ALP - 67 U/L GGT - 61 U/L
I showed these to the doctor and asked for a CT which he was happy to, even though he said the results were only slightly raised? Had the CT scan on Monday, and just got the letter. Everything is fine except this comment "The liver is normal size and outline, but shows an increase in echogenicity consistent with fatty liver" I haven't spoken to my doctor, but I already knew I had it because I asked the technician if she saw anything. I haven't had a follow up from the doctor yet.
I know without the actual imaging it's hard to give me an answer to this, but does this sound like, including my blood results it's at an advanced stage? Or have I managed to catch it early?
I have already started back on a clean diet, full of frozen veg, brown rice and chicken, bananas, almond butter and vegan protein shakes with no sugar. It's been 4 days and I've lost 10lbs, which is expected the more muscle you have the more water you tend to hold when eating crap.
I have no issues with eating clean to get rid of it and help my liver heal, I've done it for long enough when I was bodybuilding. But once it is healed. Can I still enjoy a cheat meal once or twice a month, obviously not to the extent I was before, with proper portion control, or am I stuck with eating like this forever?
I know what I've done was the cause of it, but I do very much enjoy making, going out for and eating food that isn't great for you, so as much as I could manage to eat clean for ever, I don't this my sanity will cope!

Hello! This post is mostly a vent about the difficulty to access tests and to be truly heard by doctors. I had an appointment for yet another decline in my sight yesterday, only to be told the same thing again. And yes, I am 27M, which is probably making my diagnosis all the more difficult since it's mostly seen as an illness found in women mostly. I'm overweight now, but when symptoms developed I was pretty skinny (1m68, 55kg). My obesity is recent (started 2 years ago from psych meds).
I've had my first symptoms when I was 13/14. It started as mild headaches I would have once or twice a week. My parents, like a lot of people back then, accused my computer of causing my headaches - so I never truly opened up about them further, because it would always be the same conversation. When I told that to the doctor, I only got paracetamol and the case was closed. I don't blame anyone for this though, the symptoms were not as bad as they got later and I suspect that I had already started minimizing them.
Fast forward, end of high school, I'm 17 and I noticed for the first time that my eyesight had progressively dropped. I have worn glasses since age 3; I know what hyperopia looks like and so far, glasses were correcting it very well. It was different. I started noticing tiny blind spots around the optic nerve. The letters were "split" and "flickery" but I could still somewhat read, it only required more energy on my part. I loved reading before that, but I slowly lost the motivation to partake in this activity.
To provide an example, I can't clearly distinguish D vs Q vs O, H vs N, etc... Which leads to dyslexia-like symptoms (I am definitely not dyslexic, took the tests a long time ago).
I managed to get my driver's licence without any issue. At 18-19, when I was attending university, I started getting worried about my vision and my headaches. They were increasing in intensity and frequency. I could now tell that they felt like tension headaches, mostly located on the right and on the back of my head. I also developed muscle weakness located in the upper arms, shoulders, and oh boy, my neck does hurt almost constantly.
Tinnitus also joined the party. I had experienced pulsatile tinnitus in my early teens, then it disappeared on its own, and when I was 20, it came back. Right ear : a continuous high-pitch ringing. Left ear : the continuous pulsatile hum. Not a heartbeat, but I can definitely tell that blood circulation is involved in that sound (due to loudness variations).
At 23, I brought my concerns again to my GP. No exams. Still at 23, my ophtalmologist describes "an anomaly" on my retina. There are extremely clear choroidal folds. They are pretty big, depart from the optic nerve, are parallel, horizontal and symmetric. Now, what would they do? Exams? Nah. "Come back if it gets worse". It's already pretty bad but okay!
At 24, I experience severe mood disorders and get diagnosed with bipolar disorder by a psychiatrist. I had an episode of mania after taking SSRIs prescribed by my GP, which prompted me to seek psychiatric help as I was spiraling down emotionally and financially.
At 26, I talk again of my chronic pain with the GP. My blood was very normal so I just got Tramadol to use on the worst days, otherwise I used the usual Paracetamol. Tramadol made me feel a little fuzzy and it distracted me from my issues, but it did not solve them. I stopped taking it.
At 27, nowadays... Another progression of the disorder. It is extremely frustrating because I was paying attention to my diet, fixed my vitamin deficiencies and stabilized my mood disorder. But one thing remains, it's the headaches, the eyesight getting worse over time, the tinnitus, and the pain in my neck-shoulder area. My night vision is decreasing, which led to yesterday's appointment to the ophtalmologist.
I described my night vision loss, the "flickering" of letters, we talked some more about the choroidal folds. Or the fact that I can see the "shadow" of my heartbeat in my eyes. At this moment, I was not freaking out but I was worried for my eyesight. My blind spots are now noticeable even without me paying attention to them. In binocular vision, each eye compensates for the other, so I can more or less function. But when I try to read a book, it's physically straining.
The usual tests didn't show anything significant, so I left with yet another glasses prescription and that was it. She laughed and told me "We can't repair your retina so you have to live with that".
I sleep significantly more than I used to because that's the only way to get a pause; yet I'm always tired. Physically and mentally. Right now, I don't feel depressed but I have moments of extreme lethargy. Just lying in bed doing nothing.
I phoned my doctor yesterday. I'm in the "anger" phase now. We discussed and we determined that it would be good to have an appointment and maybe, just maybe, FINALLY have an MRI and some tests done at the hospital. After 10+ years of complaining to various doctors about my chronic headaches, chronic pain, alarming vision loss, hearing decrease.
We are going to rule out any tumor (I think I'd probably be dead if it was cancer, because of how long it took to get there), and explore cerebrospinal fluid anomalies and similar things.
I am extremely afraid of spinal taps. I don't do this for pleasure, hell no. I just want to know what the hell is wrong in my head and whether I'm in danger or not. Strong indications of something similar to IIH, but the GP remains open to anything else. Next episode on Wednesday. I kinda hope I will get a diagnosis because if I'm told "Yeah we don't know, just live with it" another time at the hospital I might lose it.

Here is my blood test from last August 2023.
https://imgur.com/a/PlrrS51
I'm asking because I have all sorts of health issues mainly stemming from IBS-C, gingivitis, eczema on scalp and hands and strong dust mite allergy/slight asthma because of it and I'm constantly fatigued and tired. I ruled out a lot of stuff including sleep apnea but that does not seem to be the culprit.
I'm tired all day, no matter how much sleep I get. I'm depressed, brainfog and got chronic constipation since I was a baby.
I always was depressed, had bad anxciety, POTS, brainfog and constant fatigue. Since autmn of last year when turning 30, I hit an all time low. It never was as bad as that. It's so bad that I don't want to go on like this anymore. I have goals and needs in my life which I cant chase and achieve anymore. I sleep 6h or 10h, wake up like I was drinking all night, get up, "sober up" and can be functioning around 2h after that and 2-4h later I get tired again with a "nap mouth". By that I mean sudden tiredness with a lot of sweet saliva in my mouth.
I always had that nap mouth wit sweet saliva when tired. Is that a sign of some sort of diabetes?
It is not Vitamin D, I was always badly deficient (5-20mg/mL) and cleared that up, currently hovering around 80-100mg/mL. No change in anything listed above.
I eat all sorts of meats and veggies often, I barely eat processed foods. I do sometimes get sugar cravings but very rareley. If I still it, it won't come back quickly. I eat some bread, pasta or pizza, but also very rarely.
I did carnivore and keto. Energy for physical activities like hiking were through the roof, but still digestive issues and everything else.
My mother had her thyroid removed because of some kind of knot/overgrowth and has to supplement because of it.
My self administered thyroid test from Mai 2022:
TSH 2.12 mIU/L
ft4 1.37 ng/dl
ft3 0.37 ng/dl
My self administered thyroid test from April 2024:
TSH 2.06 mIU/L
ft4 1.45 ng/dl
ft3 0.37 ng/dl
As ferritin was 460ng/ml at the time of the last test, I'm asking if transferrin and CRP can be used to tell if you have too less or too much ferritin because I'm going to take another test of different things by myself, as multiple doctors are not helping at all. I will also test ferritin again to see if it increased or decreased. I was also drinking a beer or two every 1-2 days at the time. I know it could be hedetary hemochromatosis but currently I want to be realistic because of my onset inflammatory issues, thus high ferritin overshadowing the real amount of iron im absorbing.
On my list for the next self administered test in a few days I have the following things I want to test:
Iron, Ferritin, Transferrin, CRP
B12
Folate
Homocystein
Glucose, HbA1c
AST/GOT, GGT
ALAT GPT
Allergies (different ones)
Blood panel small/big
SHBG
Vitamin D (just to see if it dips or if my maintenance dose is correct)
Zinc
I'm happy about any comment in any direction as I don't know anymore what to do. I will go to an endo and get my thyroid levels professionally checked but don't have much hope.
Thanks so much in advance.

Honestly sometimes I think advocating for treatment is the hardest part of having a rare disease! This is going to be a freaking novel, but the tl;Dr is that I don't understand why doctors can't fucking communicate with each other, let alone with patients!
My daughter (7) has factor XI deficiency and probably also hEDS. She just had her fourth surgery to attempt to repair some middle ear damage, and because this is the fourth time we decided to go with a different surgeon at a different hospital.
Her hematologist, Dr G, is the head of pediatric hematology at the University hospital, he's absolutely wonderful and very easy to get ahold of as a patient. When we met with the surgeon at this hospital, I gave him the three-page surgery guideline sheet and Dr G's cell.phone number. Anesthesia called a week later saying they were uncomfortable handling a rare bleeding disorder, and I reminded them of the instructions sheet and told them to please call Dr G with any questions. A month later and no news, I called to check in. They could not schedule surgery until anesthesia signed off, and anesthesia still hadn't talked to Dr G. I said that's unacceptable, we need a date. They called back the next day with a date for pre-op, and surgery is the following week.
Three weeks before the surgery date we get a call that they are moving the surgery two more weeks back, but still come for pre-op. Fine.
Pre-op here (Austria) is a whole thing. We met with ENT to discuss her case. We had a hearing test. We went back to ENT. A bunch of residents looked in her ear and asked questions. We got sent to triage to confirm height, weight, and baseline vitals. We met with an anesthesiology resident who blew off the bleeding risk because her factor level was 52 last time they measured it. I pointed out that was in 2022, and it's irrelevant, and asked to speak to someone higher up.
We saw someone higher up in anesthesiology who suggested we postpone the surgery until we have met with hematology. I pulled out the hard copy of the instructions from Dr G, pointed out that he also had a copy in his file right in front of him, and patiently went through it with him. I said, again, call Dr G. Here is is cell number. Or I can call him right now if you'd like. But I promise he'll tell you to do exactly what he's written out for you. He tried to say that 52 is a normal value, and I pulled out the 2008 treatment guidelines that say anything below 70 is abnormal, and patients with this gene mutation have an increased bleeding risk despite often having factor levels above 50 so it should be considered an autosomal dominant form. I pulled out a paper from January of this year that has a very clear table for risk management during surgery of patients with factor levels under 70. Finally he agreed to follow the hematologist's plan. Great. I sign some things and we go get Boba tea.
She has the surgery. The anesthesiologist gives her the first infusion during surgery as instructed. We get back into the room and all seems well. Honestly I'm not paying mich attention to what they are giving her because she requires my full attention to comfort her. Did I mention she has sensory issues? Yeah. Anesthesia recovery is rough for her all around.
About 12 hours later she says her ear feels wrong. I look over and I can see the bandage filling up with blood. I call the nurse. She says blood is normal, I say sure but she has a bleeding disorder so can we just have the doctor check. Nurse, visibly annoyed, calls in the charge nurse, who says it's normal and she's not going to bleed to death from her ear. I'm like yeah I understand blood is normal, but I still want to talk to the doctor. A nice young resident is summoned, who says as long as the blood isn't pouring out and down her neck it's fine, but with her bleeding history they will check it every hour and in the morning I can speak to his supervisor during rounds.
Morning rounds come. I ask about the infusion, and the doctor says again the blood on the bandage is normal. She tells the charge nurse to keep rotating ibuprofen and paracetamol for pain as needed and I cut in to remind them that she can't have NSAIDs. The doctor asks why. Because she has a bleeding disorder. The doctor says her labs were normal and then leaves before I can follow up.
At breakfast she gets a nose bleed. While a nurse is handling the bloody nose I go out to the station and ask nicely what pain meds she's been getting. Oh, ibuprofen. Yeah, she can't have that. The nurse blanches. I ask when her next infusion is, and the nurse says it was cancelled. I ask why, and she says the doctor didn't think it was necessary because her labs were normal. I ask to speak to the doctor.
A new doctor comes in, I hand him the plan from Dr G. He blanches and says, "oh yes she should be getting this infusion! I'll get it."
Two hours later... No infusion. I go back to the station and ask the charge nurse. She rolls her eyes and says, "Two doctors told you it wasn't necessary."
Yes, but the third doctor then said she should have it. So I think we need to talk to someone higher up now.
An anesthesiology resident is summoned. She explains that they reviewed her case during rounds yesterday and her boss felt that the treatment was unnecessary. I explained that when I met with anesthesiology three weeks ago, they agreed to follow this plan, that's why we all went ahead with surgery here. I pull the papers back out, go over the data, and ask her to at least call Dr G.
Ten minutes after she leaves, a very annoyed nurse comes in with the infusion.
When we finally see the surgeon that afternoon he says something about how the bleeding risk is so low, he does not think I should be pushing so hard for this unnecessary treatment. Thankfully my husband was in the room to keep me from absolutely losing it. My husband, bless him, just says, "Well since it's a rare disease we tend to trust whatever the specialist says we should do, that seems pretty reasonable."
I left feeling like shit. Like maybe I was pushing for something unnecessary and just annoying everyone for no good reason. I'm not a doctor. My husband reminded me that I am this pushy because I've nearly died three times myself when doctors dismissed my bleeding risk. It's unfortunate that I have to advocate but I'm only really asking them to do what the specialist told them to do, which is very reasonable.
That night she has a weird moment of dizziness and nausea, and she just looks wrong. The nurse takes one look at her and rushes off to get an doctor. They do a bunch of tests and ultimate she recovers, vitals are stable, the doctor says it's not uncommon for kids to have some odd lingering effects of anesthesia but they will keep a close eye on her and stop the infusions.
I ask why he wants to stop the infusions. He says he's worried about a possible blood clot, and I ask of that risk is higher than the risk of a brain bleed. The nurse rolls her eyes and I say something like, look, I know I've been a pain about her getting these, but, how much do you actually know about factor XI and the risk of thrombosis with this drug? And he admits he doesn't actually know anything about either. It's a really rare disorder, but the computer is telling him that a level above 50 doesn't require treatment and he knows that giving clotting factors should theoretically raise the risks of a thrombosis event.
So once again I explain the role of factor XI in the clotting cascade. I tell him that the computer is wrong and the international standard for treatment is now under 70. I ask him to read the plan from Dr G and he tells me he has, and that actually anesthesiology spoke with Dr G that morning and that's why they started the infusions.
NO ONE ACTUALLY CALLED HER HEMATOLOGIST UNTIL THEN!!! I had to fight with so many nurses and doctors and the reality was I WAS RIGHT.
So I asked him to do what the hematologist ordered, and he agreed to restart the infusions. But seriously WHY is medical care always like this??? Why am I always having to fight with doctors to get them to just listen to each other???? What's the point of having hematology write a plan if you won't follow it anyway???

I'm asking because I have all sorts of health issues mainly stemming from IBS-C, gingivitis, eczema on scalp and hands and strong dust mite allergy/slight asthma because of it and I'm constantly fatigued and tired. I ruled out a lot of stuff including sleep apnea but that does not seem to be the culprit.
I'm tired all day, no matter how much sleep I get. I'm depressed, brainfog and got chronic constipation since I was a baby.
I always was depressed, had bad anxciety, POTS, brainfog and constant fatigue. Since autmn of last year when turning 30, I hit an all time low. It never was as bad as that. It's so bad that I don't want to go on like this anymore. I have goals and needs in my life which I cant chase and achieve anymore. I sleep 6h or 10h, wake up like I was drinking all night, get up, "sober up" and can be functioning around 2h after that and 2-4h later I get tired again with a "nap mouth". By that I mean sudden tiredness with a lot of sweet saliva in my mouth.
I always had that nap mouth wit sweet saliva when tired. Is that a sign of some sort of diabetes?
It is not Vitamin D, I was always badly deficient (5-20mg/mL) and cleared that up, currently hovering around 80-100mg/mL. No change in anything listed above.
Here is my blood test from last August 2023. https://imgur.com/a/PlrrS51
I eat all sorts of meats and veggies often, I barely eat processed foods. I do sometimes get sugar cravings but very rareley. If I still it, it won't come back quickly. I eat some bread, pasta or pizza, but also very rarely.
I did carnivore and keto. Energy for physical activities like hiking were through the roof, but still digestive issues and everything else.
My mother had her thyroid removed because of some kind of knot/overgrowth and has to supplement because of it.
My self administered thyroid test from Mai 2022:
TSH 2.12 mIU/L
ft4 1.37 ng/dl
ft3 0.37 ng/dl
My self administered thyroid test from April 2024:
TSH 2.06 mIU/L
ft4 1.45 ng/dl
ft3 0.37 ng/dl
As ferritin was 460ng/ml at the time of the last test, I'm asking about transferrin and CRP because I'm going to take another test of different things by myself, as multiple doctors are not helping at all. I will also test ferritin again to see if it increased or decreased. I was also drinking a beer or two every 1-2 days at the time. I know it could be hedetary hemochromatosis but currently I want to be realistic because of my onset inflammatory issues.
On my list for the next self administered test in a few days I have the following things I want to test:
Iron, Ferritin, Transferrin, CRP
B12
Folate
Homocystein
Glucose, HbA1c
AST/GOT, GGT
ALAT GPT
Allergies (different ones)
Blood panel small/big
SHBG
Vitamin D (just to see if it dips or if my maintenance dose is correct)
Zinc
I'm happy about any comment in any direction as I don't know anymore what to do. I will go to an endo and get my thyroid levels professionally checked but don't have much hope.
Thanks so much in advance.