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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22260
Experience:  Over 20 yrs of Family Practice
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My foot is puffy

Customer Question

My foot is puffy
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Chip replied 1 year ago.
Just the one foot?
Customer: replied 1 year ago.
Yep. When i press on it it turns white and then takes many seconds to return to normal color
Expert:  Dr. Chip replied 1 year ago.
Just suddenly happened? No pain or itching? Does it make an indentation when you press with your thumb?
Customer: replied 1 year ago.
I kinda noticed it this am because my sandle felt tight across the top of my foot. And no it doesnt create an indent
Expert:  Dr. Chip replied 1 year ago.
Hard to say with just one foot. If it were more generalized it could be thyroid, fluid overload, low salt. I worry a little about a possible deep venous thrombosis in a leg vein with something like this so, old story--you need to have it looked at right away
Customer: replied 1 year ago.
Seriously? Im in Rochester. I dont even know where I would go to get examined.
Expert:  Dr. Chip replied 1 year ago.
Just telling you my thoughts since you brought it up.
Customer: replied 1 year ago.
Done with the scan for today
Expert:  Dr. Chip replied 1 year ago.
OK
Customer: replied 1 year ago.
Do you think itll be normal
Expert:  Dr. Chip replied 1 year ago.
You keep asking that--I think so but I can't be sure
Customer: replied 1 year ago.
I want someone to diagnose whats wrong with me.
Expert:  Dr. Chip replied 1 year ago.
They haven't finished yet so be patient
Customer: replied 1 year ago.
But if this is normalThen i wont have a diagnosisHow long does it take mag citrate to work
Expert:  Dr. Chip replied 1 year ago.
Mag citrate takes arou 12 hours to work
Customer: replied 1 year ago.
Yuk
Expert:  Dr. Chip replied 1 year ago.
Maybe less--depends
Customer: replied 1 year ago.
Im neevous for this scan tomorrow
Expert:  Dr. Chip replied 1 year ago.
You're nervous a lot--why so much with a simple scan?
Customer: replied 1 year ago.
Well first of all im not known for laying still for long periods of time. And secondly what if they find a tumor
Expert:  Dr. Chip replied 1 year ago.
What if's again--natural to have that worry but it won't be long now. And it's not fun to lie still like that but you can do it. By the way--you need to rate that last, very long page.
Customer: replied 1 year ago.
Im just scared
Expert:  Dr. Chip replied 1 year ago.
I know but really I don't think they'll find a tumor
Customer: replied 1 year ago.
I worry they wont have a diagnosis besides chronic abdominal pain and ulcer, nos
Expert:  Dr. Chip replied 1 year ago.
We're just going round and round with this--you have to wait until they finish their evaluation
Customer: replied 1 year ago.
I hate waiting
Expert:  Dr. Chip replied 1 year ago.
We all have to wait some time and this hits your control issue--a good example of how we don't have any control over certain things and a good opportunity to practice letting go
Customer: replied 1 year ago.
What if they dont give me a diagnosis
Expert:  Dr. Chip replied 1 year ago.
What if questions are also a control issue--it's a complete waste of energy in a case like this to ask what if
Customer: replied 1 year ago.
Just answer it
Expert:  Dr. Chip replied 1 year ago.
No because I don't know exactly how to answer it. I think it will involved not using PPI's and Zantac and maybe switching to something like Reglan but it just makes no sense to think that the MAYO won't give you a diagnosis--they will
Customer: replied 1 year ago.
Fine dont be frustrated with me
Expert:  Dr. Chip replied 1 year ago.
Not frustrated but let's just not do the what if thing.
Customer: replied 1 year ago.
Im sorry
Expert:  Dr. Chip replied 1 year ago.
That's OK--I just have to say that to a lot of people since it's such a natural thing for them to do
Customer: replied 1 year ago.
What questions should i ask the mayo dr tomorriw
Expert:  Dr. Chip replied 1 year ago.
I gave you that list already
Customer: replied 1 year ago.
Ill have to see if i can find it. I think im
Dehydrated
Expert:  Dr. Chip replied 1 year ago.
Not likely with a swollen foot
Customer: replied 1 year ago.
Im being serious here. My pee is super dark, my mouth tongue and lips feel dry
Expert:  Dr. Chip replied 1 year ago.
You'd know if you were dehydrated just by knowing if you've had enough fluids today.
Customer: replied 1 year ago.
Ive had like 16 oz of fluid. I know you are going to say its not an excuse but i dont feel well
Expert:  Dr. Chip replied 1 year ago.
Well, up to you about drinking any more fluids since it's just a commonsense way to keep from being dehydrated. Now, enough of this particular thread
Customer: replied 1 year ago.
Nite
Expert:  Dr. Chip replied 1 year ago.
Nite
Customer: replied 1 year ago.
My pain is unbearable
Expert:  Dr. Chip replied 1 year ago.
I can't do anything about that and you know it--it's really a waste of time for you to tell me that
Customer: replied 1 year ago.
Why are you being so mean lately? Im taking 10 grams of fiber daily. But i still only go every 3rd day or so. Why is that? Should i switch to miralax
Expert:  Dr. Chip replied 1 year ago.
Not mean at all--I just can't tell you anything except to get it checked out. I noticed you asked about it with another expert and he told you the same thing--ER. What do you expect us to say when you say you've got unbearable abdominal pain? You don't need the Miralax and again with what you eat I don't expect you do go every day even though they told you you should--and I'm not even sure why they said that.
Customer: replied 1 year ago.
I have beem eating about 1200 calories thank you very much
Expert:  Dr. Chip replied 1 year ago.
I wasn't saying you weren't doing well there--I don't make innuendos with comments. I just don't know why they want you to have a BM every day
Customer: replied 1 year ago.
I dont want to do this scan
Expert:  Dr. Chip replied 1 year ago.
Too bad. And by the way, if you could manage 1200 calories a day you can also up the fluids which will both keep you hydrated and maybe help with the BM's.
Customer: replied 1 year ago.
Wow you are so nice and caring. I havent really eaten in a day and a half. As i dont feel well
Expert:  Dr. Chip replied 1 year ago.
What do you want me to say when you whine about not doing the scan? I can't be there to hold your hand so saying something like that is just chatting. So why did you try to--I won't say lie here--be devious with me about the 1200 calories, implying that that's what you've had on a daily basis?
Customer: replied 1 year ago.
I have eaten 1200 calories except
The last couple
Days. I wast devious
Expert:  Dr. Chip replied 1 year ago.
So where are we going with this?
Customer: replied 1 year ago.
Idk but i will let you know how my appt goes. Im done with the scan
Expert:  Dr. Chip replied 1 year ago.
OK
Customer: replied 1 year ago.
Btw i wasnt being devious
Expert:  Dr. Chip replied 1 year ago.
It came off that what but whatever
Customer: replied 1 year ago.
I am really incredibly nervous
Expert:  Dr. Chip replied 1 year ago.
About what?
Customer: replied 1 year ago.
About the results
Expert:  Dr. Chip replied 1 year ago.
You'll just have to wait until they're available--you've been stewing about this for days
Customer: replied 1 year ago.
They said my dr will have the results when i see him today
Expert:  Dr. Chip replied 1 year ago.
Then just wait until then--not much longer
Customer: replied 1 year ago.
But you think itll be normal? Are you done thinkimg it crohns
Expert:  Dr. Chip replied 1 year ago.
No on the Crohn's as yet and how many times do I have to tell you I think it'll be normal?
Customer: replied 1 year ago.
Whys wont you stop thinking its crohns
Customer: replied 1 year ago.
Hes still not convinced i dont have a tumor He wants to do an upper EUS to check for tiny tumors
Expert:  Dr. Chip replied 1 year ago.
What all did he say?
Customer: replied 1 year ago.
That the scan was normal but since my gastrin was elavated he thinks i have a tiny tumor that the scan coulda missed.
Expert:  Dr. Chip replied 1 year ago.
Did you tell him about the bad pain and that you hadn't eaten in two days?
Customer: replied 1 year ago.
Yes and he said its from the ulcers. He gave me an rx for Amitrytaline and increased the ranitidine
Expert:  Dr. Chip replied 1 year ago.
OK. Did you happen to ask him what's next if he doesn't find a tumor?
Customer: replied 1 year ago.
He said repeat gastrin level in 8-12 weeks
Expert:  Dr. Chip replied 1 year ago.
Does he think the gastrin level being elevated is causing the problem?
Customer: replied 1 year ago.
Yes he does
Expert:  Dr. Chip replied 1 year ago.
OK. So I guess you're still worried?
Customer: replied 1 year ago.
Ya. He specifically said he thinks its a tumor
Expert:  Dr. Chip replied 1 year ago.
Did you ask what's done if it is?
Customer: replied 1 year ago.
No i dont want to know.
Expert:  Dr. Chip replied 1 year ago.
OK
Customer: replied 1 year ago.
They wanna do the EUS on friday
Expert:  Dr. Chip replied 1 year ago.
Sorry--had to opt out because I was blocked. So can you swing Friday?
Customer: replied 1 year ago.
Idk. My boss hasnt called me back yet.
Expert:  Dr. Chip replied 1 year ago.
Sorry--keep getting blocked
Customer: replied 1 year ago.
Do i need to open a new ?
Expert:  Dr. Chip replied 1 year ago.
No, I think we're OK for now but get back to me in about two hours
Customer: replied 1 year ago.
I am so fricken scared.
Customer: replied 1 year ago.
How do i stop being scared
Expert:  Dr. Chip replied 1 year ago.
Well it's scary but I wish you had friends to fall back on
Customer: replied 1 year ago.
Would you be scared
Expert:  Dr. Chip replied 1 year ago.
No--honestly I wouldn't be
Customer: replied 1 year ago.
Why?
Expert:  Dr. Chip replied 1 year ago.
Well, first let me ask--why exactly does it scare you?
Customer: replied 1 year ago.
Because i coukd have a tumor. I guess im afraid of the unknown
Expert:  Dr. Chip replied 1 year ago.
But why exactly, if you had a tumor, would that scare you?
Customer: replied 1 year ago.
I dont really know
Expert:  Dr. Chip replied 1 year ago.
Well, would it be the fear that you might die?
Customer: replied 1 year ago.
No i dont think i would die from it. It might be the fear if needing surgery to remove it
Expert:  Dr. Chip replied 1 year ago.
OK--the only reason I asked is so I could tell you that it wouldn't scare me because I don't fear death and certainly I wouldn't fear surgery
Customer: replied 1 year ago.
Could i die if i had a tumor?
Expert:  Dr. Chip replied 1 year ago.
Well, since you've had ct scans that were normal, if it were a gastrinoma and there were no metastases, that's about 98% curable with surgery alone
Customer: replied 1 year ago.
Would it be a simple surgery or complex
Expert:  Dr. Chip replied 1 year ago.
Depends on where it was
Customer: replied 1 year ago.
This is his dictation so far

Mrs. Miller comes for followup visit for evaluation of the results of the octreotide scan. The octreotide scan was negative. There were no signs of a tumor. This is consistent with the negative CT scan. These results were shared with the patient, and we had a discussion about neuroendocrine tumors and gastrinomas. Seems like her gastrinoma _______?_______ microscopically therefore we are trying to complete the assessment with an upper endoscopic ultrasound. Once this has been completed we will have further recommendations. In the meantime, the patient mentions that her pain is not well-controlled. Therefore, we recommend to try to fill in the prescription of the AcipHex as prescribed in prior appointment. We are going to decrease the ranitidine to 300 mg twice a day, continue the Compazine which has been working for nausea, and we are going to add amitriptyline 25 mg p.o. daily as a neuromodulator. We recommend that the patient continue on the MiraLAX and fiber for her constipation and use magnesium-based products as needed for epigastric pain.
Expert:  Dr. Chip replied 1 year ago.
Why the blank with the question mark there?
Customer: replied 1 year ago.
I. Dont think his transcriptionist knew what he said.
Expert:  Dr. Chip replied 1 year ago.
Well he basically is saying if it were a gastrinoma it would be nonmetastatic and like I said that would be 98% curable in patients.
Customer: replied 1 year ago.
Does it make it sound like he thinks there is one
Expert:  Dr. Chip replied 1 year ago.
I don't think he does but it would help greatly do know what was in that blank space
Customer: replied 1 year ago.
He told me he thinks i do
Expert:  Dr. Chip replied 1 year ago.
Well, if he did, why did you want me to try to read his mind when you already knew what was in his mind? Sometimes I just don't understand you
Customer: replied 1 year ago.
He told me they are going to look specifically at my pancreas and small bowel
Expert:  Dr. Chip replied 1 year ago.
OK that's where they commonly occur but where are we going with this?
Customer: replied 1 year ago.
Idk. Sorry. Nite
Expert:  Dr. Chip replied 1 year ago.
Nite
Customer: replied 1 year ago.
What if my boss doesnt let me have the day off?
Expert:  Dr. Chip replied 1 year ago.
Reschedule the test, of course--and it could be done by your GI
Customer: replied 1 year ago.
My gi doesnt do EUS
Expert:  Dr. Chip replied 1 year ago.
We're starting to chat again--you can eventually get the test one way or the other
Customer: replied 1 year ago.
Sorry.
Expert:  Dr. Chip replied 1 year ago.
That's OK--anything specific to talk about before we close this page?
Customer: replied 1 year ago.
Why do you think the mayo dr thinks there is a tumor
Expert:  Dr. Chip replied 1 year ago.
Simple--you've got an elevated gastrin level. Like I told you before, atrophic gastritis with an inability of the stomach to make acid can cause that, but since it doesn't seem that's what you've got, you have to consider a tumor and do everything to try to find one.
Customer: replied 1 year ago.
I was hoping when the scan was done he would drop the idea of a tumor
Expert:  Dr. Chip replied 1 year ago.
Well, with the scan there's more evidence you don't have one but he needs the EUS to make sure. The fact that the scan was negative is really very good news
Customer: replied 1 year ago.
I hate all of this
Expert:  Dr. Chip replied 1 year ago.
I know but you're almost finished with it. Anything else?
Customer: replied 1 year ago.
I guess not.
Expert:  Dr. Chip replied 1 year ago.
OK--page is long again so let's close and get back to me when you need to
Customer: replied 1 year ago.
My boss said shed rather i wait
Expert:  Dr. Chip replied 1 year ago.
So schedule it when you can--we need to close please.
Customer: replied 1 year ago.
Last thing my anxiety will kill me if i have to keep waiting for this test
Expert:  Dr. Chip replied 1 year ago.
No it won't kill you and hold onto the fact that I think the EUS is still going to show no tumor. And talk to your boss because it sounds like this is the last time you'll have to be off work for this.
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22260
Experience: Over 20 yrs of Family Practice
Dr. Chip and 2 other Health Specialists are ready to help you
Customer: replied 1 year ago.
Getting scoped tomorriw
Expert:  Dr. Chip replied 1 year ago.
OK--let me know how it goes
Customer: replied 1 year ago.
Last time they had a hard time waking me up. They gave me 10 mg of versed. 100 mcg of fentanyl and 50 mg of benadryl. Do you think that was too much
Expert:  Dr. Chip replied 1 year ago.
Way too much Versed--1 or 2 mg at most and I'd drop the fentanyl to 50 mcgm

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