Tag Archives: Symptoms

DR. C’S JOURNAL: WHAT IS PNEUMOCYSTIS PNEUMONIA?

Pneumocystis is found in the respiratory tract of most mammals and Man. Pneumonia from this organism was extremely rare or unknown before the advent of AIDS.

When the lymphocyte count of a person with AIDS drops below 500, or especially 200, pneumocystis pneumonia is a frequent complication. Symptoms include cough, fever, rapid breathing, and shortness of breath.. The chest x-ray typically shows a “ground glass” appearance, caused by fluid inside the air sacs and throughout the lung. Treatment is usually with trimethoprim sulfa.

Immunosuppressive therapy is often given for organ transplants and auto immune diseases these days. Patients and doctors should be on the lookout for pneumocystis symptoms in this situation. Even long-term corticosteroids can produce enough immunosuppression to allow pneumocystis to invade the body.

Pneumocystis Jeroveci is the causative organism, and used to be called pneumocystis Carini. Doctors suspect this disease when an immuno-suppressed patient, especially AIDS , has a dry cough, with pneumonia and  a very low oxygen concentration, more severe than expected.  Fluid taken from the lung shows several  organisms in little sacks or cysts.

Treatment is with sulfonamids, if they are tolerated. Cortisone must be given not the same time to prevent a severe reaction from absorption of the dead organisms. Pneumocystis is a yeast-like fungus and is also discussed under opportunistic fungal infections.

The following article will give you more information.

—Dr. C.

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DR. C’S JOURNAL: EFFECTS & SYMPTOMS OF LONG COVID

COVID-19 is admittedly a pandemic and has caused much economic and social disruption in the world. Now we learn that it may not be over after a few of weeks of illness. LONG COVID is now an accepted syndrome.

You can tell because of the many clinics for handling it being set up by the NHS in England, and millions in research money being directed towards a solution.

The most disturbing thing to me is that infected but asymptomatic or mildly ill people may get this condition, and have one or more symptoms for a long time .Certainly, those more seriously ill develop long Covid symptoms more commonly.

Long Covid is taking its place with chronic fatigue syndrome, posttraumatic stress disorder and post ICU syndrome as poorly understood conditions. They may in fact be taking place simultaneously, even if they are not identical.

The cause  can  be due to continuing viral infection in older or immune compromised individuals. Vascular damage is another reason that could account for the widespread involvement of practically any organ system that doesn’t go away after a few weeks.

Structural damage to the alveoli of the lungs and other organs can also play a role, which would account for shortness of breath as a prominent persistent symptom. Although it has not been highlighted in the articles that I have read, auto immunity can also be playing a role in long Covid.

This would go along with The myocarditis rarely caused by the mRNA vaccines; perhaps some of the protein sequences of the spike proteins have similar shapes to some human tissues. Name a symptom, and you’ll probably find it listed among the 50 odd symptoms mentioned in the Wikipedia article on long Covid, which is appended to the end of this article.

The most prominent symptoms include extreme fatigue, mental fog, and shortness of breath. Treatment is mainly supportive and general. After ruminating on this condition, it’s going to be quite a while before Yours truly wants to breathe in other peoples air spaces; I plan to continue masking in public, distancing and avoiding large groups.

That being said, I am planning to go out to eat dinner tonight, and can hopefully be placed at the edge of the room. I will inquire as to the vaccination status of our waiter. The people at my table will all be doubly vaccinated, which is not complete assurance of safety, but will help make me feel relatively comfortable.

I also plan on getting a booster shot as soon as it is available. Hopefully, the vaccine incorporating the special mutations of the delta virus will be soon available. You don’t want to be infected by this nasty, promethian shape-shifter. Take care.

–Dr. C

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THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #44: SYPHILIS (STD)

Syphilis is a venereal disease, or STD, that is unusual,  unique in many ways. First of all, it is one of the few major diseases to have originated in the Americas, the New World, and carried back to Europe most likely by Columbus; Popularized by “guns germs and steel”, the infectious disease traffic was almost all the other way, most famously smallpox which decimated the Native Americans.

A second unusual characteristic is that it’s treatment(penicillin) is known, cheap, easy, and yet Syphillis infects millions of people yearly, most commonly to be sure in the developing world, but also large numbers in America where is helped by AIDS, and spread by men having sex with men.

A third unusual characteristic  is that syphilis can mimic practically any disease. There are three stages.  The first stage is a painless ulcer, usually on the genitals.  After a few weeks, the second stage develops, showing a widespread rash and other symptoms.  After a few more months, problems develop in the heart, brain, or growths ( gummas) in many other areas .

When I was in medical school we used to go to an old peoples home to listen for aortic regurgitation, and observe the neurologic symptoms of syphilis patients. Syphilis is still a cause of aortic  insufficiency, if untreated.

Treponema pallidum, The causative agent, is also unusual. It has a very small geome, and has many missing cellular mechanisms, making it dependent upon Homo sapiens, it’s only known Reservoir. The fragile but very active organism will die in a few hours outside of its human host. Like it’s confederate,AIDS, The infection can easily spread from mother to child with devastating consequences. It is one of the major diseases for which pregnant mothers are tested.

Syphilis is one of the best arguments for being monogamous. If this can’t be, remember that syphilis is easily treatable, and that you should report any unusual illnesses to your doctor.

—Dr. C

DR. C’S JOURNAL: CAUSES & SYMTPOMS OF INSOMNIA

Sleep has many functions, among which are clearing the body of toxins and consolidating memory. The exact amount we need is determined by age, and genetics among another things. From what I’ve read, eight hours is required, plus or minus an hour.

That being said, there are a few  among us who are super sleepers. Going back in history this probably included Mozart and Thomas Edison: They could live healthy, productive lives with as few as three or four hours of sleep. Genetic mutations, including changes to the Orexin Gene receptor account for true super-sleepers.

Familial fatal insomnia is a genetic disease operating through prion proteins, and does not illuminate the problem of insomnia. In most people  there are two major forces which determine the onset of sleep, the circadian rhythm, and sleep pressure.

The TIMING of the sleep varies from morning larks to night owls. These shifts in the circadian rhythm is also genetic, involving many genes, including PER and CRY. Diurnal rhythm can apparently be changed, But with difficulty.

The sleep pressure is caused by the gradual daily accumulation of adenosine in the system, apparently resulting from the stripping away of the phosphate groups from the energy currency, ATP.  This can be assuaged by caffeine containing drinks, such as tea or coffee. Caffeine temporally blocks the effect of adenosine, but when it wears off, you usually go right back to your fatigue state.

INSOMNIA occurs when you do not get as much sleep as you need, and are tired in the daytime. This is a major problem for a lot of people.

Insomnia has many causes. Stress will cause an increase in Cortisone in the bloodstream which interferes with sleep. Caffeinated drinks nicotine and other stimulants can cause you to have difficulty falling asleep, and alcohol will help you fall asleep but will often result in awakening in the middle of the night when the alcohol is metabolized.

Depression, Parkinson’s, chronic pain, gastroesophageal reflux and any other medical conditions can interfere with sleep. Sleep apnea, often associated with overweight and heavy snoring, is a special problem that sometimes needs the help of a sleep specialist.

Some poor habits such as reading in bed, doing work in bed, eating at bedtime, and heavy exercise just before bed can also be a problem.
A regular routine of Preparing for sleep, such as brushing and flossing and taking a warm shower are also helpful; you can get more details by looking up “sleep hygiene”.

A lot of people take a nap, but this can cause some difficulty in going to sleep. Among things you can do to prevent insomnia include living an active life, making your bedroom comfortable for sleep, and using your bedroom ONLY for sex and sleep.

Please refer to the accompanying Mayo clinic article for more organized information.

—Dr. C.

Mayo Clinic articlehttps://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167


Tachycardia: Types, Causes & Symptoms (Mayo Clinic)

Tachycardia is the medical term for a heart rate over 100 beats per minute. There are many heart rhythm disorders (arrhythmias) that can cause tachycardia.

Types of tachycardia

There are many different types of tachycardia. They’re grouped according to the part of the heart responsible for the fast heart rate and cause of the abnormally fast heartbeat. Common types of tachycardia include:

  • Atrial fibrillation. Atrial fibrillation is a rapid heart rate caused by chaotic, irregular electrical impulses in the upper chambers of the heart (atria). These signals result in rapid, uncoordinated, weak contractions of the atria.Atrial fibrillation may be temporary, but some episodes won’t end unless treated. Atrial fibrillation is the most common type of tachycardia.
  • Atrial flutter. In atrial flutter, the heart’s atria beat very fast but at a regular rate. The fast rate results in weak contractions of the atria. Atrial flutter is caused by irregular circuitry within the atria.Episodes of atrial flutter may go away themselves or may require treatment. People who have atrial flutter also often have atrial fibrillation at other times.
  • Supraventricular tachycardia (SVT). Supraventricular tachycardia is an abnormally fast heartbeat that starts somewhere above the lower chambers of the heart (ventricles). It’s caused by abnormal circuitry in the heart that is usually present at birth and creates a loop of overlapping signals.
  • Ventricular tachycardia. Ventricular tachycardia is a rapid heart rate that starts with abnormal electrical signals in the lower chambers of the heart (ventricles). The rapid heart rate doesn’t allow the ventricles to fill and contract efficiently to pump enough blood to the body.Ventricular tachycardia episodes may be brief and last only a couple of seconds without causing harm. But episodes lasting more than a few seconds can become a life-threatening medical emergency.
  • Ventricular fibrillation. Ventricular fibrillation occurs when rapid, chaotic electrical impulses cause the lower heart chambers (ventricles) to quiver instead of pumping necessary blood to the body. This can be deadly if the heart isn’t restored to a normal rhythm within minutes with an electric shock to the heart (defibrillation).Ventricular fibrillation may occur during or after a heart attack. Most people who have ventricular fibrillation have an underlying heart disease or have experienced serious trauma, such as being struck by lightning.

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THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #33: The Common Cold’

The common cold is one of the most frequent of human diseases, and causes billions of dollars in lost work yearly. I haven’t heard of many cases of colds or flu recently, in the Era of Covid.

Distancing, mask wearing, and hand washing prevents colds too. The common cold spreads by AEROSOL transmission, and autoinnoculation into the nose from contaminated surfaces, just like Covid.

By far the most common cause of the Common Cold is the RHINOVIRUS, of which there are 100 serotypes. Coronaviruses, Influenza, Parainfluenza, RSV and enteroviruses also produce cold-like symptoms. The large number of viruses causing the Common cold makes developing an effective vaccine difficult.

Adults eventually encounter most of the serotypes prevalent in their community, and don’t catch many colds. However, when adults travel, they experience a new, unfamiliar group of viruses endemic to their destination. How often do we take a trip and come back with a Cold, or worse. We lack immunity to the microorganisms we have not yet encountered, just like children.

When I was in pediatric allergy practice, I feared nothing so much as the cold temperatures in October. The kids would come back to school, and start getting colds, averaging 7-8 per year. It is commonly thought by researchers that cold symptoms are not produced so much by viral damage to the respiratory membranes, as by the body’s immune response to those viruses.

My experience confirms that opinion. A cold was a worry for my patients. Rhinovirus infection often triggered a severe ashmatic response, sometimes sending the children to the ER if not the Hospital ICU.

It was the allergic reaction to the virus that caused the severe wheezing. After the epidemic of Covid subsides, and becomes endemic, don’t give up all of your newly-acquired habits. Hand-washing, distancing, and even masks prevent other respiratory disease transmission too.

–Dr. C.

INFOGRAPHIC: ‘DIFFERENCES BETWEEN COVID-19, THE FLU AND ALLERGIES (2020)

COMMENTARY:

The infographic by the allergy and asthma foundation aims to distinguish between Covid, Influenza and allergy. I would like to discuss more than symptoms. Covid and Influenza are both caused by invading infectious viruses.

Allergy is an over-response by the sensitized body to harmless proteins from the environment Covid and Influenza viruses cause direct damage to the lining membranes of the respiratory tract provoking a protective response by the body which produces inflammation in the nose and lung. Rhinitis, bronchitis and pneumonia result, depending on the site of the inflammation.

The symptoms of Allergy are far different from both Influenza and covid. ITCHING of the nose, eyes and skin is the hallmark of allergic Rhinitis, allergic conjunctivitis and Hives, respectively. Influenza or Covid Infection of the nose, eyes and airways can produce sneezing, redness, coughing and difficulty breathing, but not usually itching.

Fever is characteristic of Influenza and Covid, but not of uncomplicated Allergy. Asthma can result from either infection or allergy, but is a separate beast, caused by release of different inflammatory cytokines.

The ASTHMATIC REACTION shows itself in the BLOCKAGE of breathing of air OUT of the lung, on EXHALATION. This blockage on exhalation in asthma is heard as wheezing, a musical sound. Just ask the wheezing person to take a deep breath IN, which should be easier, and then breathe out as fast as possible, which should be slower and more difficult. Fever is not a feature of uncomplicated Asthma. Influenza and Covid.

Both produce FEVER, fatigue, aching and usually coughing. Covid has the greater linkage with Coughing, which often progresses to Shortness of breath. Both Influenza and Covid can produce a sore throat and runny nose. LOSS OF SENSE OF SMELL is unique to Covid, although if your nose is stuffy, the sense of smell can be impaired. Influenza preys on the very young, which are generally spared from Covid.

If you are careful about social distancing and wear masks in public, and get sick, Covid is more likely, since COVID IS MORE CONTAGIOUS THAN INFLUENZA. Covid protections will probably result in fewer cases of Influenza this winter.

To summarize,both the “flu” and Covid 19 are infectious conditions, vastly different from allergy, which is a derailed body defense mechanism. Any of the three can result in an asthmatic reaction, though the fever of influenza often lessens the Asthmatic response to that condition.. Covid is much more contagious and severe than influenza and can cause more widespread organ damage. Be sure to practice MASK WEARING AND SOCIAL DISTANCING.

If you have asthma and it worsens, in my opinion, this favors covid. My asthmatic patients often got better with the fever of Influenza. If you have a CHILD that gets sick, it is more likely to be Influenza than Covid.

–Dr. C