medical


Snoopy-Typing-Away-1-CVV14J0D95-1024x768

Giving old mice blood from young mice can reverse age-related impairments in learning, memory and neuronal function, according to US research.

These findings, published in the journal Nature Medicine, suggest that circulating factors from young blood could reverse the effects of aging in the brain.

Future studies in humans are necessary before similar conclusions can be made about effects in people.

A second set of studies in the journal Science joined a young and old mouse together with a single circulatory system and found that age-related impairments and DNA damage in the muscle stem cells, or satellite cells, of the older mice were reversed.

Tony Wyss-Coray of Stanford University and colleagues found that repeated injection of blood from young, three-month-old mice into old 18-month-old mice can improve their performance in learning and memory tasks.

Heating the blood, which alters the structure of its proteins, before injecting it into older mice abolishes these effects, suggesting a circulating heat-sensitive factor reduces these positive effects.

The aged mice showed a reversal in age-related impairments in their brains at the structural, molecular and functional level.

Of course as blood cells have a 90 day life span this [potentially] would mean a transfusion every 90 days at minimum.

Over the last couple of days I have been trying to help a fellow trader and weightlifter with an injury. It can serve as a salutary reminder that seeking help early is usually a good idea.

Can we take a break from the markets for a second?

I am the type that doesn’t step foot inside of a doctors office or a hospital unless I need stitches.
But I can’t take it anymore. My left shoulder has some serious issues.

This is something that has bothered me for over a year now, but it keeps getting worse. I know its getting worse is because of the pain I get at the gym.

I know its a long shot to diagnose someone online, but here it goes:

1. The point of pain is when my arm is parallel to the floor, I cross my arm “across” my body and I raise upwards.

2. My doctor thought it was a rotator cuff injury

3. Both x-ray and MRI showed no problems

4. My doctor then says it must be that “the ball came out of the joint” – wouldn’t that show up in the x-ray?

5. The exercises that are most painful are; military press, pull-ups and tricep raise (behind head)

6. After a workout, my left arm feels broken, while my right arm feels “pumped”

To be honest, I don’t care about the pain.

What I do care about is that I can’t lift heavy and my whole left arm looks like a little bitch (probably like chivo) compared to my right.

I’m supposed to see a physiotherapist, but for some reason I imagine these people to be something like a yoga instructor.

I guess I have a hard time believing that swimming in a pool with a bunch of old people doing some stretches is going to fix my problem

or whatever it is they are gonna tell me to do.

I don’t know if its related but starting just last week, I could barely raise my head to get out of bed because the left side of my neck, lat, shoulder blade hurt so bad.

Any advice? I don’t want to waste another 6 months.

Thanks in advance.

go2 received numerous replies, diagnoses, wild guesses and tips. I won’t bother with any of them. The most egregious was from someone claiming to be a doctor. As with almost anything, a medical diagnosis is made on numerous steps being completed. The first is a comprehensive case history. It can be done online, it’s not ideal, far from it, but it can elicit some useful information:

duc says:
July 15, 2011 at 3:20 pm

go2,

In any diagnosis there is a methodology.

Onset:
You mention that this has been worsening for about a year. [i] Can you remember what you were doing? In other words can you link a causative event? [ii] You state that it is worsening. Is this just lately? To leave it so long suggests that it was not so bad, bearable, then suddenly started to worsen, now involving Csp, upper back. [iii] Any symptoms radiating into arm/fingers? Numbness, pins&needles, pain, burning or other odd symptoms? [iv] You continued to train with the injury, has your training of the injured area changed or been modified in any way just recently? [iv] Did you ever rest/rehab it from the original injury, or did you simply train through the pain?

Distribution
You have described the anatomical position where pain is triggered. [i] Where exactly, in that position does it hurt? [ii] Does the pain travel anywhere else? [iii] At rest is there any pain? [iv] At rest if any pain, does it travel anywhere else?

Nature of pain
Is the pain present at rest? [ii] Is the pain sharp in nature upon movement only, or [iii] is the pain constant, dull ache in intensity, increasing with movement?

Aggravating/Relieving Factors
Apart from movement already mentioned, anything else reproduce the pain? [ii] How quickly can you reproduce the symptoms? [iii] Has this changed?

What if anything provides relief? [eg. anti-inflamms, heat, ice, positioning, etc] [ii] How quickly/slowly is relief provided by the factor employed?

Medical History
Are you using any anabolics [due to the legal implications answer by e-mail] If so [i] what drug [ii] what doseage [iii] what duration. AS can create muscular tears, avulsions through creating physiological imbalances.

To date, you have not been diagnosed. Without a diagnosis, no treatment protocol can be either recommended, nor implemented. The purpose of a diagnosis is to provide a baseline, to which expected results from a treatment plan can be tested against, this is a prognosis. Like many things, diagnosis is not a science, it is an art, an art based on empiricism.

To date, all the responses in the comments section, while well meaning are uninformed guesses, the most egregious being the fraud claiming to be a doctor.

The prior, constitutes the history, somewhat condensed. The second part of a diagnosis is an examination. This would constitute both an active and passive examination, possibly including a systems examination. This for your case would likely constitute a neurological clinical exam. The purpose of a physical exam is to isolate anatomical structures, and reproduce the symptoms, thereby identifying the structure. This structure and pain produced is confirmed via its function.

Imaging, MRI etc are not diagnostic. They are used to confirm/reject a diagnosis based on a thorough history and clinical examination. Anything less is negligent.

I can certainly help you through the first part, and give you some ideas as to possible areas that would require attention in any physical exam.

jog on
duc

The response:

go2jupiter says:
July 16, 2011 at 10:01 pm

duc,

Onset:

[i] I don’t remember exactly but I probably injured it at the gym (military press, tricep extension behind head) or I could of “fallen” on it.
[ii] Yes, its just been worsening lately. I’ve never been this lean before. <8% bf. So maybe the extra cushion is gone.
[iii] I get a pain through the "bicep" / arm bone. It feels like the arm is going to break like a twig. It doesn’t go right to my elbow, but more like straight down “in the middle”.
[iv] My workout has remained pretty constant
[v] Never done rehab, I just trained through the pain.

Distribution:

[i] Sharp pain is at the side and side/front of the delt. During rest sometimes at the back of the shoulder. Its hard to pinpoint + the recent neck pain and this why its been hard for me to fix it.
[ii] Pain travels down "the bone" of my arm
[iii] There is an ache at rest and occasionally a "pulsing" discomfort in my shoulder
[iv] The pain present at rest does not travel

Nature of pain:

[i] There is discomfort in my shoulder at rest but I wouldn't call it unbearable
[ii] Sharp pain during movement, dull ache at rest

Removing my shirt by lifting my arms causes pain but other than that I rarely put my arms in a position for it to hurt.

Instead of a pumped feeling like my other arm, it feels like its about to snap.

Aggravating/Relieving Factors:

[i] The best way to reproduce the shoulder pain is to raise my arm upwards while crossed over my body with palm facing down. The pain down my arm comes with lifting during any exercise.
[ii] Symptoms are reproducible every time I try
[iii] No this has not changed

What if anything provides relief?

[i] The only thing that provides relief is not lifting with it

Medical History:

[i] I am not using any drugs or medication for the pain

Also, the left side of my chest (the side with injured arm) is larger than my right chest

I guess during chest exercises the left arm is just not taking any weight and transferring it to the chest instead.

Lifting weights does not always produce the sharp pain in my delt, (bench press for example) but the “weakness” in my arm is there for every exercise, as if the arm can’t handle any weight at all. (due to the shoulder instability?)

I tried my best to answer, thanks for taking the time.

Further questions:

duc says:
July 17, 2011 at 2:24 am

go2,

A few more questions for clarification:

[i] When you perform Military Presses how do you set up for the exercise? Do you use a Smith machine, some other form of machine, or do you use olympic bar + plates. If free weights: off a support stand, or, do you clean the weight to shoulder position?

[ii] You state that you could have fallen on it: expand on this, do you partake in some form of martial arts, possibly at work, accident that stands out in your memory, etc.

You state:

[i] The best way to reproduce the shoulder pain is to raise my arm upwards while crossed over my body with palm facing down. The pain down my arm comes with lifting during any exercise.

This is adduction of the glenohumeral joint. Functionally, it is a relief to the supraspinatus tendon that passes through the space created by the acromion and humeral head and would be expected to relieve symptoms. Abduction of the glenohumeral joint would be expected to aggravate symptoms, reproducing them.

Can you expand on this area?

Lifting weights does not always produce the sharp pain in my delt, (bench press for example) but the “weakness” in my arm is there for every exercise, as if the arm can’t handle any weight at all. (due to the shoulder instability?)

There is tremendous pressure through the glenohumeral joint in any form of bench press. If there was glenohumeral “instability” this I suggest would be very apparent. In addition, particularly in a free weight bench press, the stabiliser muscles, rotator cuff musculature, amongst others, would be strongly stimulated, causing pain. That no pain is caused is intriguing.

Weakness of the arm however is a different.

You mention;

Also, the left side of my chest (the side with injured arm) is larger than my right chest

Is there muscular atrophy of the upper extremity? Tricep mass, bicep mass?

Any family history of bone cancer, or any cancers?
Your age?
Your occupation?
Would any past occupations expose you to toxic material of any description: chemicals etc?

Any additional symptoms that you may have that you do not associate with the symptoms in the arm/shoulder?
The weight loss that you mention:

[ii] Yes, its just been worsening lately. I’ve never been this lean before. <8% bf. So maybe the extra cushion is gone.

[i] how caused? Are you eating less? Dieting for a particular reason? Increasing aerobic based exercise for any particular reason?

If none of the above, can you explain the weight loss in a rational manner?
If no explanation, then how long have you noted the weight loss? Is it predominantly fat, muscle, or a mixture? From what areas of the body? Is it general? Or site specific?

I'll wait to hear the answers.

jog on
duc

At this point we have moved to e-mail, so the communication must remain private. Suffice to say we have moved onto the second stage of a diagnosis, the physical testing. This is performed in the clinic and comprises both active and passive tests. These may be augmented through a systems test, and this case would require a neurological examination at the very least. Now as I am in NZ and the patient is in I think the US, obviously I won’t be performing the tests, but they can for the most part be reproduced by the patient and reported. We’ll see.

The point is this: if you have an odd presentation, and you visit your GP, this is the sort of questioning that you should expect. If you are fobbed off with 5mins and a prescription for XYZ, your doctor is not providing a professional service. Lose him.

The second point is this: don’t leave something that starts out as a minor problem, to grow into a major problem, unless you absolutely know what the problem is, and can take the necessary steps to correct or rehabilitate the problem.

This appeared the other day on the StockTwits list of bloggers.

Question: What do you call a D student who graduated medical school? Answer: Doctor

How do you know if the guy that gropes and tests you got an A or a D in med school? You don’t. It’s like boarding a 747 after the pilot went on a coke binge, killed his wife, left her on the kitchen floor, had a few Mimosas and then started up the engines to fly you over the Atlantic. It’s a trust thing, you have no control.

I always said if I had anything really wrong with me I would want Dr. House to do the operation as he is the only Dr. I could see myself trusting. Unfortunately he isn’t real so that ain’t happening.

Over the past year I have had some intermittent stomach pain. I chalked it up to a bad burrito or the occasional Big Mac. Lately though, the pain was more frequent, and over the last two weeks the pain which used to last twenty minutes, has duration of three to ten hours. The way I can describe this pain is simple. If you remember the last scene of Braveheart when Mel Gibson had his entrails ripped out, well, that’s how it feels.

So I did what I have never done. I went to WebMD because of extreme curiosity. My Mom had her gall bladder removed years back and that is what I thought it might be. Anyway after my search, I found that I had about ten out of ten of the symptoms of gall stones. I knew it had to be gall stones.

I went to my Doctor the next day and described my symptoms. I told him that my Mom had gall bladder issues and I thought I may have the same thing. He looked at me thoughtfully and said ” I really doubt it, I think you may have really bad indigestion”. He sent me for a full abdominal sonogram and an upper gastro test which required me to drink about a pint of a chalk like substance.

After the test I described my symptoms again to this new Doctor in extreme detail. He was the” specialist”. He looked at me and said something that I never though an expert in this area would say. ” Hmm, I never heard of this”, he then asked “Do you have stress?” I responded that I was on wall Street for over twenty years, trade stocks and have two teenagers, what do you think Dr. Shit For Brains? No I didn’t call him shit for brains, but I wanted to.

Friday I got the results back. It was my gall bladder. Schmucks.

This is a minimally invasive procedure these days and I will have this useless organ ripped out in the next week or two. I just hope i don’t get the D student.

Obviously this chap is somewhat underwhelmed by the diagnostic prowess of the doctors in encountered. Using WebMD he feels rather superior, that based on matching 10 symptoms, although some of them might have actually been signs, although the distinction seems to have made no impression on our self diagnosing patient.

The tests he was subjected to, did actually confirm the diagnosis. Now further investigations, which are scans of various types, are all listed under further investigations, and are not diagnostic, rather they are confirmatory of an existing diagnosis [or not as the case may be] So all ended well.

Well possibly not.

The last sentence highlights the problems associated with a lay diagnosis, and unfortunately the doctor seems at fault here again: the gallbladder is very far from a useless organ. It has myriad physiological functions. The primary function being the emulsification of fats in the digestive and absorption process. Fats are a component of every cell in the body. They are particularly important within neural cells, which for this chappie, involved in the financial markets, is a rather crucial area. Of course the other major issue is the aetiology of the gallstones, what, why and how they formed. This pathological process that resulted in a gallstone, could and likely does, have a pathology that acts as an early warning to a more serious, or continuing pathology.

The one that immediately leaps to mind is excess estrogen. Yes, I know estrogen is a female hormone, but it is ubiquitous, and in the male with gallstones, is a prime suspect. The issue with estrogen levels that are high in men is the increase in cholesterol that they induce. High cholesterol levels lead inexorably to atherosclerosis, which commonly manifests as Coronary artery disease. Depending on other lifestyle factors, are you a fat bastard, are you a fat bastard because you are a lazy bastard guzzling beer, fags and high fat while watching a 3 hour football game on TV, can lead to what’s commonly described as a heart attack, add in some age, and you start to multiply the probabilities.

Now when I went to Medical school, there were indeed the A students, and there were the D students. I have to say the D students were pretty damn dangerous and should never have been unleashed on the public. In fact the whole Medical industry is dirty, so dirty that I have never bought stock in the industry, I may have daytraded a few issues, but never on an investment basis.