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by SomeSayMarryMoney on April 19th, 2009
How long are prepackaged salads good?
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by tamsets on May 19th, 2012
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You're reading I'm curious if anyone can help me with a DDX. I woke up today perfectly fine; ten minutes later I felt like someone hit me in the sternum with a hammer. No history of chest pain; no family history of cardio problems; pain slowly faded over 45 min.
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I don't drink but I do smoke; the pain isn't a burning like from ulcers/lacerations, though - it's more like a heavy sore pressure around the top of the sternum, but obviously under that region. There is no pain from swallowing; just that first drink. Almost as if the esophagus was too small to allow for comfortable passage. I do have a history of upper respiratory issues, and it's getting hot here, so I've had my a/c on but it's warm and humid outside. That might be part of it; I don't know. Frankly, there's not much a doctor here is going to be able to do for me; they'll slap a convenient diagnosis on it and do nothing to really figure out what's really happening. Taiwanese doctors tend to be pretty bad at figuring things out; they type a few symptoms into a computer and it spits out the meds it thinks you should take. I'm starting to wonder if it's respiratory...
by MisterKnowItAll on April 19th, 2009
that's actually a good bit to go on...give me a few more minutes with some resources and I'll get another list together. And ulcers in the esophagus can present with a more dull pain...the nerves in your GI tract aren't really great with sensation so you can get mixed signals about pain quality and location, so don't rule it out just yet.
by SomeSayMarryMoney on April 19th, 2009
just to verify- you're in Taiwan now? And do you know any more details about your respiratory issues?
by SomeSayMarryMoney on April 19th, 2009
I won't - the fact is that I drink a lot of Coca-Cola and last night ate a steak, spicy fried chicken, and french fries. But this seems like a fast onset of pain, and it also seems odd that it wasn't there when I woke up - it took 5-10 minutes after waking up, and me getting up and moving around, for it to present. I dunno...
by MisterKnowItAll on April 19th, 2009
sorry, but I'm probably going to keep thinking of questions every few minutes. Anyone you know been sick? Any fever/chills? Nausea/ vomiting/diarrhea? Cough? Flu-like symptoms?
Pain anywhere else (jaw, back...)? Dizziness? Changes in vision, hearing, balance?
by SomeSayMarryMoney on April 19th, 2009
What details do you want? I have chronic sinusitis; I am just relatively susceptible to upper-respiratory issues. Bronchitis, etc. Post-nasal drip from the sinusitis can lead to sore throats or a build-up of mucus in the lungs, but that hasn't happened much since I've been in Taiwan and certainly not recently. My money's on respiratory issues; the liquid passing down the esophagus might have just put pressure on inflamed lung tissue and exacerbated the condition. I dunno...aren't DDX fun? lol
by MisterKnowItAll on April 19th, 2009
It's all good. No one else is sick. No fever. Heartrate normal; I assume BP is, too. No nausea/diarrhea/vomiting. No cough. No real pain elsewhere; I have some back pain, but it's because I've been hunched over a computer while sitting on my couch for the last for hours. lol No neurological symptoms that I can tell; no dizziness or sensory issues.
by MisterKnowItAll on April 19th, 2009
I honestly live for this stuff. Literally- I'm a med student. So, if we're thinking lungs (and I'm sure you know your body well enough to be on the right track)...are you by any chance really tall?
by SomeSayMarryMoney on April 19th, 2009
also, was the onset that sudden?
by SomeSayMarryMoney on April 19th, 2009
The onset was extremely sudden. Woke up - urinated - masturbated laying down(increased heartrate/respiration?) - stood up maybe a minute later and it felt like, suddenly, someone had punched me in the sternum. I am 181cm; 82kg (5'11" 180lbs). Not especially athletic but not totally out of shape either; "average," I guess.
by MisterKnowItAll on April 19th, 2009
The tall question probably seems like a total non-sequitur, but I was thinking maybe an aortic dissection? The pain is usually sharp, though, so not sure about that. Another possibility is pneumothorax (really common in young men), but usually that's one-sided pain. Pulmonary embolism is on the list now too, and although yours isn't a typical presentation, it's similar enough that I don't think anyone would rule it out without some more tests. or, maybe it was god punishing you for masturbating.
by SomeSayMarryMoney on April 19th, 2009
i think if I were you, I'd go see a doctor if only to rule out the more life-threatening stuff. or maybe a minister... and on that note, i really must get back to studying (the boards are coming up). good luck, and feel free to keep me informed (otherwise I might begin to think you died of something really unimaginably terrible). i hope you figure this out!
by SomeSayMarryMoney on April 19th, 2009
It could be a pulmonary embolism but my BP is generally textbook (though I can't measure it right now...) and my heartrate, while high, is always around 80-90 bpm. No tachycardia beyond the usual (which isn't quite fast enough to qualify); no dizziness or other symptoms of hypoxia; there is some pain when breathing but I can't tell if it's the lungs themselves or simply the expansion of the chest cavity. The only reason I brought up masturbating was that I thought it might have led to some sort of hyperventilation-based causation, but it's unlikely. I'd just hate to leave any potential cause out, you know? If this is God trying to make me miserable, when I do die from some weir thrombosis, I'm going to kick him squarely in the balls before he ships me off to Hell.
by MisterKnowItAll on April 19th, 2009
lol good luck with the boards - I don't think I'm going to die, but an EKG might not be a bad idea. I'm going to smoke my first cigarette of the day (I'm sure that just thrills you lol) and I'll post back when I'm done and see if there's any effect.
by MisterKnowItAll on April 19th, 2009
hey- feeling any better? did you ever figure out what was wrong?
by SomeSayMarryMoney on May 10th, 2009
I have absolutely no idea; it was apparently some sort of fluke. It's been a month and I haven't had any issues. Lately I'm smoking les cigarettes, more cannabis, and sleeping like a normal human being, for what that's worth. How's the tests?
by MisterKnowItAll on May 10th, 2009
i've been doing nothing but study for over a month now. but there was a case presentation that reminded me of your symptoms. young male presented with heart-attack like chest pain. turned out he was severely anemic because of a GI disorder. The anemia was essentially starving his heart. really strange. but thanks to our conversation, i looked like a pro when we went through the differential diagnosis.
by SomeSayMarryMoney on May 25th, 2009
That is most crucial; I'm glad I could help a little bit in my own way. I can just see a bunch of med students looking at you like, "Do you watch a lot of House, or what?" lol "No, I just get on AnswerBag when I'm bored." I'm sure they'd love that. The internet is like the bane of doctors' existence. Can you imagine having a patient like me? I'm a friggin' nightmare...lol
by MisterKnowItAll on May 25th, 2009