Medical Board Question, Can You Get It Right and What was the Cause

[gator1776]

A 29-year-old woman presents to the emergency department with a 3-day history of progressive weakness, sensory loss in her lower extremities, and urinary incontinence. The patient is healthy with no medication use other than her flu vaccination obtained 2 weeks prior. On physical exam, her cranial nerves are intact, she is profoundly weak in all extremities with 2 out of 5 motor strength on MRC scale, and she is areflexic. All modalities of sensation are profoundly decreased below the neck. Vital signs: blood pressure 84/45 mmHg, pulse is 52/min, respirations are 12/min, and oxygen saturation is 91%. A sagittal T2 and post contrast T1 cervical spine MRI are shown. Which of the following is the most likely diagnosis?

A. Anterior spinal cord infarct
B. Copper deficiency
C. Guillain-Barre syndrome
D. Transverse myelitis
E. Vitamin B12 deficiency

Just for fun, lol

 

[DCandtheUTBand]

My guess is D probably from the vaccine causing inflammation and the pre-existing injury.

If its then D do you do a steroid shot, prednisone or some other treatment?

 

[gator1776]

My guess is D probably from the vaccine causing inflammation and the pre-existing injury.

If its then D do you do a steroid shot, prednisone or some other treatment?

There was no pre-existing injury
But the answer is D, it is transverse myelitis as demonstrated on the MRI of the spine.
It is one of the exceedingly rare complications of vaccinations, which is why I thought this group would love this one.
And IV steroids remains the first line treatment

 

[DCandtheUTBand]

There was no pre-existing injury
But the answer is D, it is transverse myelitis as demonstrated on the MRI of the spine.
It is one of the exceedingly rare complications of vaccinations, which is why I thought this group would love this one.
And IV steroids remains the first line treatment

OK, assumed the areflexia was due to an injury. I couldn't read an MRI although the one of my wifes neck was obvious in the narrowing. She had CV surgery. A Johns Hopkins grad working at Vandy.

 

[gator1776]

OK, assumed the areflexia was due to an injury. I couldn't read an MRI although the one of my wifes neck was obvious in the narrowing. She had CV surgery. A Johns Hopkins grad working at Vandy.

Hope she is doing well.

 

[DCandtheUTBand]

Hope she is doing well.

4 years ago this month. She has residual nerve damage but is much better. She has regained strength in the affected arm and now has a normal gait again.

 

[Capt Ron 1]

A 29-year-old woman presents to the emergency department with a 3-day history of progressive weakness, sensory loss in her lower extremities, and urinary incontinence. The patient is healthy with no medication use other than her flu vaccination obtained 2 weeks prior. On physical exam, her cranial nerves are intact, she is profoundly weak in all extremities with 2 out of 5 motor strength on MRC scale, and she is areflexic. All modalities of sensation are profoundly decreased below the neck. Vital signs: blood pressure 84/45 mmHg, pulse is 52/min, respirations are 12/min, and oxygen saturation is 91%. A sagittal T2 and post contrast T1 cervical spine MRI are shown. Which of the following is the most likely diagnosis?

A. Anterior spinal cord infarct
B. Copper deficiency
C. Guillain-Barre syndrome
D. Transverse myelitis
E. Vitamin B12 deficiency

Just for fun, lol

Out of my league! LOL

 

[gator1776]

Out of my league! LOL

I thought you would enjoy it though because it is a proven, albeit rare vaccine side effect

 

[Capt Ron 1]

I thought you would enjoy it though because it is a proven, albeit rare vaccine side effect

Just have heard about Myocarditis in young males.

 

[fatman76]

Just have heard about Myocarditis in young males.

Friend of mine got Guillain-Barre syndrome.

He's still fighting atrophy, muscle/limb control, fatigue and pain. BUT - they had a get together a few weeks ago and it was sort of his "coming back" party.

He's also working part time remotely, which has to make him feel better (he's a radiologist). His days of procedures are done but he can see, talk and think.

I doubt he ever fully recovers. Mandatory Covid booster.

 

[gator1776]

Friend of mine got Guillain-Barre syndrome.

He's still fighting atrophy, muscle/limb control, fatigue and pain. BUT - they had a get together a few weeks ago and it was sort of his "coming back" party.

He's also working part time remotely, which has to make him feel better (he's a radiologist). His days of procedures are done but he can see, talk and think.

I doubt he ever fully recovers. Mandatory Covid booster.

That is another definitively proven risk of vaccines. I’m sorry for your friend. I hope he does fully recover eventually most people usually do.

 

[fatman76]

That is either another definitively proven risk of vaccines. I’m sorry for your friend. I hope he does fully recover eventually most people usually do.

It's been 3.5 years of fighting. First two years he was in and out of the ICU at UVA.

He doesn't expect to ever fully recover. Being a doctor and knowing "too much" probably isn't good.

 

[NavigatorII]

I STILL see morons wearing masks, sometimes double masks. It's sad AF how much low information the clueless cling to idiots like Dr Kevorkian Fraudchi's fake news..............but there it is..........front and center. And they ALL vote Dimtard. Useful idiots all.

 

[BillytheC]

I am living with 4 herniated disc’s in my neck- the pain is manageable but never goes away

 

[NavigatorII]

I am living with 4 herniated disc’s in my neck- the pain is manageable but never goes away

I got diagnosed with cervical spinal stenosis 20 years ago. I dealt with it for another 10 years, then finally gave up on physical therapy and got two titanium rods in my neck. It alleviated 80% of the pain but I'm still on a pain management schedule. Not fun but things could be worse. I still laugh at the effing idiots wearing masks, what a bunch of pussies.

 

[gator1776]

It's been 3.5 years of fighting. First two years he was in and out of the ICU at UVA.

He doesn't expect to ever fully recover. Being a doctor and knowing "too much" probably isn't good.

I would have to review the details of the case to be able to give you definitive answers, obviously, and we know you’re just doing this to antagonize, but statistically 95% of people to Gullian Barre fully recover the recovery can take up to 10 years in some cases.

If this person does not fully recover, then it is an incredibly rare version of GB or there’s something else going on such as a secondary complication from prolong weakness, which is far more likely.

I still wish him full recovery and give him my prayers. I suspect you’re embellishing, but have no way to prove that.

Now going with your theory what you’re saying is you would rather have a contractor that’s got a little bit of knowledge about building as opposed to one that is an expert on building?

Maybe you would like to have an airline pilot that’s got a little bit of experience flying planes as opposed to one that’s an expert on flying planes?

Or going with your theory, maybe you would like a president that has absolutely no experience that is very unintelligent. That’s been a total of four years in government to be our president at a time of global war? Oh wait that one might actually happen.

Some of you guys are just downright brilliant
😝😝😝😝

 

[Capt Ron 1]

I STILL see morons wearing masks, sometimes double masks. It's sad AF how much low information the clueless cling to idiots like Dr Kevorkian Fraudchi's fake news..............but there it is..........front and center. And they ALL vote Dimtard. Useful idiots all.

I so agree. It TO ME is like wearing "I am an idiot" sign on top of their head. Saw to young people wearing masks alone in their car....head shaker.

 

[Capt Ron 1]

I would have to review the details of the case to be able to give you definitive answers, obviously, and we know you’re just doing this to antagonize, but statistically 95% of people to Gullian Barre fully recover the recovery can take up to 10 years in some cases.

If this person does not fully recover, then it is an incredibly rare version of GB or there’s something else going on such as a secondary complication from prolong weakness, which is far more likely.

I still wish him full recovery and give him my prayers. I suspect you’re embellishing, but have no way to prove that.

Now going with your theory what you’re saying is you would rather have a contractor that’s got a little bit of knowledge about building as opposed to one that is an expert on building?

Maybe you would like to have an airline pilot that’s got a little bit of experience flying planes as opposed to one that’s an expert on flying planes?

Or going with your theory, maybe you would like a president that has absolutely no experience that is very unintelligent. That’s been a total of four years in government to be our president at a time of global war? Oh wait that one might actually happen.

Some of you guys are just downright brilliant
😝😝😝😝

Doc...we were lied to so much during this epidemic that it is understandable for people to question everything. If lefties have control of the info...I RIGHJT AWAY do not believe it.

Take this storm that just hit. They are calling it a Cat 3, but the highest GUST that I saw was 107. That would justify about an 80-85 mph sustained wind. They lie to us because of arrogance that they know what is better for us. That is NOTY how gubment is supposed to work. MILLIONS of people evacuated are waking up today that saw what I saw and pissed because they uprooted their lives for POSSIBLY no reason. Next time a storm comes...they will be suspicious of believing the government, and then a Michael happens where the storm intensifies instead of weakens on arrival. I answered you yesterday that I was out of my league on medical stuff. I am VERY educated on hurricanes living on the water in NW Florida for over 60 years. Just tell me like it is and let ME make my decision.

Bottom line...the gubment is NOT to be trusted...and they DO give out tainted medical advice as we saw during covid.

 

[gator1776]

Doc...we were lied to so much during this epidemic that it is understandable for people to question everything. If lefties have control of the info...I RIGHJT AWAY do not believe it.

Take this storm that just hit. They are calling it a Cat 3, but the highest GUST that I saw was 107. That would justify about an 80-85 mph sustained wind. They lie to us because of arrogance that they know what is better for us. That is NOTY how gubment is supposed to work. MILLIONS of people evacuated are waking up today that saw what I saw and pissed because they uprooted their lives for POSSIBLY no reason. Next time a storm comes...they will be suspicious of believing the government, and then a Michael happens where the storm intensifies instead of weakens on arrival. I answered you yesterday that I was out of my league on medical stuff. I am VERY educated on hurricanes living on the water in NW Florida for over 60 years. Just tell me like it is and let ME make my decision.

Bottom line...the gubment is NOT to be trusted...and they DO give out tainted medical advice as we saw during covid.

I think what the government did during Covid echoed by a dishonest press was disgusting. I think it has definitely hurt the public trust of healthcare in the United States. The public trust of healthcare in the United States has been waddling for decades for a lot of reasons beyond the scope of this discussion.

One of the hardest parts of my job every day is gaining the trust of my patience and so much of that is because of the very things you’re talking about. The government made my job a lot harder, by weaning the Covid issue into a method of controlling Americans.

I am an advocate for truth and an expert in this particular area and I also enjoy a good debate, which is why I don’t mind tilting with some of you guys about these topics from time to time, but in the end, I completely agree with what you’re saying. The government did healthcare and doctors no favors in the last five years

By the way, I was one of Fauci‘s biggest adversaries in 2020 early during all of this because I knew he was lying to the American public and @FresnoGator is my witness to this.

 

[GatorTrooper]

I think what the government did during Covid echoed by a dishonest press was disgusting. I think it has definitely hurt the public trust of healthcare in the United States. The public trust of healthcare in the United States has been waddling for decades for a lot of reasons beyond the scope of this discussion.

One of the hardest parts of my job every day is gaining the trust of my patience and so much of that is because of the very things you’re talking about. The government made my job a lot harder, by weaning the Covid issue into a method of controlling Americans.

I am an advocate for truth and an expert in this particular area and I also enjoy a good debate, which is why I don’t mind tilting with some of you guys about these topics from time to time, but in the end, I completely agree with what you’re saying. The government did healthcare and doctors no favors in the last five years

By the way, I was one of Fauci‘s biggest adversaries in 2020 early during all of this because I knew he was lying to the American public and @FresnoGator is my witness to this.

My son is a rype 1 diabetic and he was a supposed high risk of complications to covid.

Had an extremely smart dr talk to me when it first started. He explained the virus and what it would do and how no shot mask ot cleaning supply would stop it. And explained how what we were seeing on TV would not help. I was kind of skeptical because I live in a small Mississippi town and how would a Dr here have a clue 😀. But he was 100% correct in everything he told me that day. I never put on a mask never took a shot and here we are.. So i trust Dr's more now than I did before because of him.

Also the blue masks were made in my town and the boxes were changed to the make it look like they worked.

 

[Capt Ron 1]

I think what the government did during Covid echoed by a dishonest press was disgusting. I think it has definitely hurt the public trust of healthcare in the United States. The public trust of healthcare in the United States has been waddling for decades for a lot of reasons beyond the scope of this discussion.

One of the hardest parts of my job every day is gaining the trust of my patience and so much of that is because of the very things you’re talking about. The government made my job a lot harder, by weaning the Covid issue into a method of controlling Americans.

I am an advocate for truth and an expert in this particular area and I also enjoy a good debate, which is why I don’t mind tilting with some of you guys about these topics from time to time, but in the end, I completely agree with what you’re saying. The government did healthcare and doctors no favors in the last five years

By the way, I was one of Fauci‘s biggest adversaries in 2020 early during all of this because I knew he was lying to the American public and @FresnoGator is my witness to this.

I do not disagree with anything you say here. And what you talk about above is EXACTLY what I am talking about. You face trust issues to do your job because our government LIED to us, and turned a very serious pandemic in to a political football to oust Trump. What they did 100% has cost people their lives...and in many cases their health because of lack of trust. I do not think there are many on here that actually have the knowledge to debate you medically in normal circumstances, but while we were getting VERY OBVIOUSLEY lied to by the elites in the medical field...we did not know who to trust. But we DID know who NOT to trust. You are in one of those professions we pay tons of money for their services...and there is a good reason for that. I understand it is "the practice of medicine" and there are sometimes very different perspectives, but the way the government handled covid probably put you and other doctors in a situation of lack of trust for who knows how long until it goes away? I think I trust MY doctor totally..because he has been my doctor for a very long time...however if I do not know you....I am MUCH more careful than before this happened with the gubment

 

[fatman76]

I would have to review the details of the case to be able to give you definitive answers, obviously, and we know you’re just doing this to antagonize, but statistically 95% of people to Gullian Barre fully recover the recovery can take up to 10 years in some cases.

If this person does not fully recover, then it is an incredibly rare version of GB or there’s something else going on such as a secondary complication from prolong weakness, which is far more likely.

I still wish him full recovery and give him my prayers. I suspect you’re embellishing, but have no way to prove that.

Now going with your theory what you’re saying is you would rather have a contractor that’s got a little bit of knowledge about building as opposed to one that is an expert on building?

Maybe you would like to have an airline pilot that’s got a little bit of experience flying planes as opposed to one that’s an expert on flying planes?

Or going with your theory, maybe you would like a president that has absolutely no experience that is very unintelligent. That’s been a total of four years in government to be our president at a time of global war? Oh wait that one might actually happen.

Some of you guys are just downright brilliant
😝😝😝😝

Dude, seriously fvck off with the holier than thou sh!t. I gain nothing by lying or embellishing. One anecdote isn't going to change anything about anything.

And this guy and his family are close friends. I coached his kid, and we've known them since we moved here 13 years ago. Seeing them in a social situation for the first time in years was incredibly emotional. His wife finally looked like a weight had been lifted.

The guy didn't respond to treatment. He had trouble breathing on his own at times. They've finally found a med combo that seems to help but it's not sustainable, and they're working to wean him off.

His hands are almost completely wasted and contracted. His gait sucks, he swings his legs when he walks. He lost a ton of muscle mass and can only stand for about 10-15 minutes at a time. He told me point blank the odds of a full recovery are small but he's going to keep fighting. He set a goal to run a 1/2 marathon by next Spring. He isn't giving up.