Pauline Said:

Is this essay considered relevant to the topic?

We Answered:

pretty sweet. to tell the truth, i really just skimmed it through but it sounds like your on topic of how education's important to you personally, except try a few more sentences after you mention on being a doctor, like how your going to get there (besides saying your going to school). hope you get what you want too =)

Duane Said:

Reflexology query?

We Answered:

You are also breaking up adhesions in the tissue on the bottom of his feet. This can cause pain.

The first time I ever had a real reflexology session, I felt like I didn't have any lower leg/foot and was walking on air but a little while later my feet were so painful.

Keep working on them and have him walk on reflexology paths (with stones in the ground) or roll on golf balls or whatever to keep working on it to get everything out.

Fred Said:

Can I join the Green Beret, and what is the best way to train physically and mentally?

We Answered:

Where is the question?

Juan Said:

Can Anyone Explain This... Respiratory Problem I Had That I No Longer Have? Details Inside?

We Answered:

What you seem to discuss here is actually a relatively common problem. It is also usually transient. It is TYPICALLY an intercostal spasm, which is simply a spasm of the muscles in between your ribs. Sometimes, if they cramp up or spasm, when you attempt to take a deep breath, it feels like someone is knifing you. It's awful. Sometimes, if you can gain your composure and slowly breathe in (as though through a straw), that may be enough to cajole the muscles out of spasm.

It has absolutely nothing to do with asthma, which is a spasmodic contraction of the muscles surrounding the bronchial tree.

Bonnie Said:

Any medical types out there?

We Answered:

Good start on a DDx. My thoughts:

Meets all four criteria for Systemic Inflammatory Response Syndrome (SIRS - usually need 2/4). 1) High WBC; 2) Tachycardia; 3) Tachypnea; 4) High temperature. Further, "cool and clammy" and high BUN make me think he's in shock (systemic hypoperfusion of tissues). A blood pressure would be nice confirmation. With that...

Pneumonia - entirely possible. Could have led to septic shock with the picture presented.

TB - TB can present like damn near anything. Not bad to include it in the DDx, particularly with pulmonary involvement and indicators of chronic disease (underweight). Can predispose to other infection, sepsis, and the above; can cause adrenal insufficiency and get to shock that way; can get to this picture about ten other ways a well.

Other possibilities:

Myocardial infarction: can cause SIRS and cardiogenic shock, which would account for the shock-like symptoms. Usually would present with chest pain but not always. Left ventricle infarction would lead to pulmonary edema and the pulmonary finds.

Sepsis of any source (not just pneumonia) could also present like this.

Overall, I like an infectious process of some kind for this, but it could be due to any of the many inducers of SIRS.