Questions Apr 19 20111.-Recurrent Shoulder DislocationHi doctor i am 21 years old man 2years back i fall down from the bike my right shoulder was dislocated my hand turned back that time some unknown person came and he turned my handcorrect position and next day i went to hospital so doctor just given some medicine and he gaveone belt to my hand after one month i removed that n doing my work some day when i throwingthe boll it was again dislocated and with in seconds again set again so from that day whenthrowing something it getting dis located now yesterday i went to swimming pool when iswimming my hand was to much dislocated again so from yesterday to much paining i cant liftmy hand also.....so plz tell me sir Wat i have to do i have X ray also.........and is it possible to stopcontinue sly dislocation of my shoulder....Age: 19-25 yearsSex: MaleCurrent Medication, Known Allergies and Medical History were left blank.Generally, if your shoulder is wrenched upward and backward, you may dislocate it out of itssocket .Basically now, try to avoid shoulder straining movements and activities that couldpotentially produce a new dislocation. The shoulder dislocation is both painful andincapacitating. The force required is often that of a fall or a collision with another person orobject (both of which can occur during many sports). Most shoulder dislocations happen at thelower front of the shoulder, because of the particular anatomy of the shoulder joint. The bonesof the shoulder are the socket of the shoulder blade and the ball at the upper end of the armbone (humerus). The socket on the shoulder blade is fairly shallow, but a lip or rim of cartilagemakes it deeper. The joint is supported on all sides by ligaments called the joint capsule, andthe whole thing is covered by the rotator cuff. The rotator cuff is made up of four tendonsattached to muscles that start on the scapula and end on the upper humerus. They reinforce theshoulder joint from above, in front, and in back, which makes the weakest point in the rotatorcuff in the lower front. You can wear a sling, If a sling is not available, rig one by tying a longpiece of cloth in a circle (a bed sheet or towel may do nicely). A pillow placed between the armand body may also help support the injured shoulder. After a period of immobilization (usually afew weeks), slowly and gradually begin to increase the range of motion at the shoulder joint.This helps to preserve natural movement and lessen the risk of recurrent dislocation which isyour particular case here. When good progress is made with range of motion, strengtheningexercises may be added to help you to return to full function. According to the current medicalliterature, the recurrence rate for shoulder instability is highly dependent on the age of thepatient. Nonoperative care should be performed first before entertaining the thought ofsurgery. Most patients are able to rehabilitate their shoulder with rest and physical therapy. Inpatients , as your case, who have recurrent shoulder instability, operative care should be highlyconsidered. Numerous studies have shown the increased likelihood of traumatic glenohumeralarthritis in patients with multiple shoulder dislocations. Operative care may consist of both openor arthroscopic treatment of the cause of instability, and of course a Rehabilitation program aftersurgery to control pain, limitation and regain full function.
2.-Possible Psoriasis ArthritisI recently have been diagnosed with Dermititis, then I got grovers disease, then I got Psoriasisand now it seems I have Psoriatic arthritis. How is this possible in just 6 months? Is there someunderlying condition that maybe causing this? Im 58 and have been in excellent health.Appreciate any info. thank you.Age: 56-65 yearsSex: MaleCurrent Medication: Zocar, verapimil,linisoprilPsoriatic Arthritis is a type of arthritis that affects some persons who have Psoriasis. The majority ofpeople with Psoriasis are later diagnosed with joint problems that correspond to Psoriatic Arthritis. Themain symptoms are: joint pain, stiffness, swelling, they may affect any joint from fingers to Spine andmay go from mild to severe. There is no cure for the Psoriatic Arthritis what you can do is control thesymptoms when they flare and try to prevent more damage to your joints. The medications currentlyused to treat Psoriatic Arthritis include: NSAIDs, disease modifying anti rheumatic drugs (DMARDs),immunosuppressant medications and for the most severe cases: Tumor necrosis factor-alpha inhibitors.But you can help yourself for example: keeping a healthy weight, exercising regularly, avoiding strain oradditional stress in your joints, applying alternating hot-cold packs several times a day for about 20-30minutes each time, also try to get enough rest during the day.3.-Testosterone side effectsWhat sort of adverse effects can be caused by testosterone boosters such as p-6 extreme.Age: 19-25 yearsSex: MaleAnabolic steroids refer to hormones or in this case, pro-hormones that are either taken orally or byinjection that influence the bodys hormonal system to produce extra testosterone. The goal of takinganabolic steroids is to increase muscle mass. Anabolic refers to this muscle-building capability. The useof steroids suppresses the naturally occurring testosterone in the body and, in males, may lead to adecrease in testicle size (atrophy), decreased sperm production, infertility, acne and baldness. As well,the excess steroid can be converted to estrogen in males and may lead to enlarged breasts (known asgynecomastia). Liver damage may often occur, and liver cancer is a risk. Psychiatric effects of steroidsinclude excitation and depression. Aggression is common. Manic episodes of aggressive behavior areknown as "roid rage," and violence may be the outcome. Depression and suicide may also occur.
4.-MRI showing canal stenosis of cervical spineI have a lot of shoulder and arm pain, and now my Dr. thinks its coming from my neck. MRIresults: C3-4: small central disc bulge causing mild flattening of the thecal sac without stenosis.C4-5: disc bulge with superimposed soft disc protrusion causing indentation of the cord andmoderate canal stenosis. foramina are patent bilaterally. C5-6: broad central disc protrusionindentation of the cord with moderate canal stenosis. Mild foraminal stenosis bilaterallysecondary to uncovertebral joint hypertrophy with impingement of the exiting C6 root. C7:central disc extrusion extending inferiorly causing indentation of the cord with moderate canalstenosis. Foramina are patent bilaterally. What does this all mean?Age: 46-55 yearsSex: FemaleThe pain in your neck and shoulder might be due to a cervical nerve compressionyou’re yourdoctor thinks, according to the results of your recent MRI, but it would be important to rule outalso an inflammation of the peripheral nerves at the level of the arm and hand. In the youngerpatients, cervical radiculopathy may be a result of a disc herniation or an acute injury causingimpingement of an exiting nerve. In the older patient, cervical radiculopathy is often a result ofspinal canal narrowing (stenosis) from bone (osteophyte) formation, decreased disc height anddegenerative changes due to aging process. The treatment strategy usually includes: physicaltherapy program aimed to reduce pain and inflammation, and the use of anti-inflammatorymedication (“Motrin”, “Advil”), also a re-education of your posture may improve quality of life.You should be independent in a stretching and strengthening routine and continue with theseexercises under the periodic supervision of a physical therapist initially and then completely onyour own. If your condition fails to improve with a comprehensive rehabilitation program andselective injections , you may be presented with a surgical evaluation. Often, you canexperience progressive improvement over the first 6-8 weeks with conservative treatment. Ifthere is no significant improvement in this time frame, consider a surgical evaluation.5.-HIV and unprotected sex for 10 monthsIs it possible to not contract HIV after after having unprotected sex with someone for 10 months?Age: 36-45 yearsSex: MaleThe following factors are associated with an increased risk of acquiring HIV infection:Unprotected sex, receptive anal intercourse carries a particularly high risk, injection druguse (sharing needles or drug paraphernalia), occupational needle stick or body fluid splash(estimated transmission rate <0.3%), contaminated blood products (before 1985 in the
United States). Around the world approximately 40 million people are currently living with HIVinfection, and an estimated 25 million have died from this disease. In the United States, roughlyone-third of new diagnoses appear to be related to heterosexual transmission. Male-to-malesexual contact still accounts for nearly half of new diagnoses and intravenous drug use makethe remaining of the cases. In your particular case, if you are not sure about the HIV status ofthe person with who you had unprotected intercourse for 10 months or if you are feelingvery stressed out and worried, it is strongly recommended that you get tested. There is atest that can be done without using a needle. This test, called the OraQuick Rapid HIV Test forOral Fluid, gives results in 20 minutes using saliva. This test can detect only HIV type 1 (HIV-1)antibodies. Also, a negative test result does not mean you are immune to HIV, always keep inmind that engaging in risky behaviors (having unprotected sexual intercourse with an infectedperson or sharing needles or syringes with an infected person) can transmit HIV.