Octopus Overlords

Freyland wrote: ↑Fri Sep 14, 2018 10:44 amKeep us informed!

The results of the CT scan are in. The doctor explained it to me as this...

No signs of orbital cellulitis or abscesses. Sinuses and glands on the CT scan looked clear. The superior rectus muscle of the eye is swollen or thickened. She wasn't sure why I'd have eyelid edema and it wouldn't be common with this issue, but she figures that there may be something that antibiotics killed and the muscle hasn't calmed down yet. She says this rules out this being an emergency situation - unless something unsual happens over the weekend, like my eye continues to swell or closes. She did ask if I've got thyroid issues, which I don't - or am not aware of. She said that as an extreme outlier, it may be orbital lymphoma.

I need to find a PCP next week and get my blood work done to rule out thyroid issues before any more guessing is done. I'll finish the course of antibiotics I'm on, but it doesn't look like there's a lingering infection right now.

So...

Paingod wrote: ↑Fri Sep 14, 2018 1:56 pm

Freyland wrote: ↑Fri Sep 14, 2018 10:44 amKeep us informed!

The results of the CT scan are in. The doctor explained it to me as this...

No signs of orbital cellulitis or abscesses. Sinuses and glands on the CT scan looked clear. The superior rectus muscle of the eye is swollen or thickened. She wasn't sure why I'd have eyelid edema and it wouldn't be common with this issue, but she figures that there may be something that antibiotics killed and the muscle hasn't calmed down yet. She says this rules out this being an emergency situation - unless something unsual happens over the weekend, like my eye continues to swell or closes. She did ask if I've got thyroid issues, which I don't - or am not aware of. She said that as an extreme outlier, it may be orbital lymphoma.

I need to find a PCP next week and get my blood work done to rule out thyroid issues before any more guessing is done. I'll finish the course of antibiotics I'm on, but it doesn't look like there's a lingering infection right now.

So...

Thanks for the update. So my thoughts/explanations, if you will have them:

1) No abscess--> Yay!
2) Chronic thyroid issues can cause the build-up of myxedema of the eye muscles, which can in turn cause the eyes to bulge. That said, one muscle involvement, associated with infectious symptoms, seems like this is unlikely. Not saying dont get the labs, just reviewing your situation with info at hand.
3) Orbital lymphoma? As she stated, extreme outlier (especially with normal surrounding glands, but even without that detail, extreme outlier).
4) So, where my opinion on things differ is the severity of your infectious situation. The swollen muscle on the CT attaches to, and runs adjacent to, the eyeball. This is exactly the region of "Peri-orbital" (not pre-septal) cellulitis. She and I agree that your findings are better than they could be due to the previous oral antibiotic use. We differ because I see you as a partially-treated peri-orbital cellulitis and she (seems) to view you as a partially treated pre-septal cellulitis.

So, where does that leave you? Of course, follow the directions you were given and take the abx your were given. Would suggest careful follow up, and exactly as she said, if you have worsened symptoms of eye pain with movement, eye swelling, eye paralysis, vision worsening then ER is absolutely appropriate. I would argue that fever and/or headache would justify ER as well, based on the concerns I have given you. Keep us informed, and I hope to hear things are getting better!

Everyone always forgets about parasites. IIRC your have dogs and possible boarders at your house, i.e. new animals coming and going? Did your doctor ask you about pets? Even if it's not parasites I'd be inclined to think about zoonotic illness, because that's how I roll. To clarify, I'm not a doctor but I am 2-0 on Giardia diagnosis after two unrelated individuals I know spent months with their symptoms unresolved by doctors and specialists.

Eyelid edema is associated with Chagas. If that's what you have, I call dibs on your story for journal research!

Smoove_B wrote: ↑Fri Sep 14, 2018 4:39 pm Eyelid edema is associated with Chagas.

When the walls fell.

I used the expression "I probably put the thing on the thing" unironically today, in a context where the listener would have absolutely no reason to understand any of it.

If it's early onset Alzheimer's, just kill me now and be done with it.

GreenGoo wrote: ↑Fri Sep 14, 2018 5:04 pm I used the expression "I probably put the thing on the thing" unironically today, in a context where the listener would have absolutely no reason to understand any of it.

If it's early onset Alzheimer's, just kill me now and be done with it.

Orrrrrrrr.... and stay with me here..... you can look forward to playing lots of great games "for the first time"!

My wife doesn't remember any of the hundreds of movies I own so it's like a new movie all the time.

3.5) Giardia. Extremely extreme outlier, like "wtf?" outlier. Likely only considered by Giardia-obsessed Giardians who also know too much about viruses in semen.

Im in the middle of a buttermilk craving. Im drinking lots of it. I plan to make a buttermilk cornbread tomorrow. Also have plans to make a big old buttermilk pie.

Now Im wondering why they dont make buttermilk ice cream. Just use buttermilk to make it instead of cream or regular milk.

So, local election is heating up, signs all over the place and at a corner near me, I stopped to take a picture because it was cracking me up.

Typical American.

I was looking online for the best way to get rid of roaches and I finally found it................mind control.
All I have to do is work on my telepathy.

Backstory: Still swollen, but maybe not as bad. Still seeing the black dot. Still no discharge. Almost no discomfort, and far less pain when looking up, but that could be that the docs got me on ibuprofen and it may be hiding it? I've got a follow-up with the doctor this morning.

Eye comparison, Friday to Today. Still going on antibiotics, plus 800mg ibuprofen 3 times per day since Friday evening. *Edit: Saw the doctor today. Advised to continue antibiotics and 800mg 3x/day ibuprofen until antibiotics run out (maybe 4 days). They did take a snapshot of the inside of my eye and said the nerves looked good and the doc saw nothing wrong in there. A second doctor in the office that viewed my CT results said it "absolutely" ruled out orbital cellulitis... but then the consensus was that they didn't really know what was/is wrong and blood work is in order. For that, I need a PCP - which I don't have. So I'll hunt for one today.

Paingod wrote: ↑Mon Sep 17, 2018 7:22 am Backstory:

Spoiler:

Paingod wrote: ↑Tue Aug 28, 2018 7:10 amLast Thursday my right eye started swelling a little. Each day, the swelling got worse until Monday when I asked one of our doctors to take a look. Cellulitis, he says. Not sure how an infection got into my eye lid, but it did. There's no point of entry, no clogged glands or scratches. I'm on Amoxicillin and am waiting to feel better. This morning my eye is more swollen. I keep feeling warm with a mild body ache - but when I check my temp, I'm at a steady 96.8 (my norm)... so no fever, despite feeling like a fever.

Freyland wrote: ↑Wed Aug 29, 2018 1:48 am Um....
Pain with moving, especially side to side?

ER-->admission-->surgical drainage.

Periorbital cellulitis. Worth considering.

Paingod wrote: ↑Wed Aug 29, 2018 6:59 am I work for a group of eye doctors. I'd hope they get it right.

The doc I saw flipped my lid and didn't seem too concerned. He did say cellulitis, but not periorbital cellulitis. The antibiotics seem to be fighting the infection - swelling has gone down this morning from yesterday, but the pain experienced when looking up (not side to side) has not lessened. There is no pain when looking down or side to side. There is absolutely no discharge or pus. Whatever it is, it's entirely inside my eyelid.

I'm feeling a lot better today after an afternoon laying on the futon, semi-conscious and watching TV.

Freyland wrote: ↑Wed Aug 29, 2018 10:01 am Nope, wasn't suggesting they meant periorbital cellulitis, rather that was a diagnosis of concern based on the history thus far provided and a "yes" to the question I posed. Glad it's getting better.

Paingod wrote: ↑Tue Sep 11, 2018 10:04 am 10 days of antibiotics done, 4 or 5 days without now, and the infection is returning. There's a "bright black dot" that I see when I look into the extreme upper-left corner, which appears in the lower-left corner. It never went away, and neither did the inflammation. My eye got real close to looking normal a couple days ago, but has since become angry again.

One doc casually says I should go back on the antibiotics that failed to kill it, and I'm looking to get an appointment with the first one (who did the initial check & prescription) to see what he thinks.

Paingod wrote: ↑Wed Sep 12, 2018 7:50 am Yesterday I was running a mild fever and saw one of the other doctors in the practice. She said "preseptal cellulitis" (apparently another name for periorbital cellulitis - good call Freyland!). No one is discussing surgical drainage yet, but she did start me on a course of different antibiotics. Cephalexin. She had me "jump start" this with two doses about 5-6 hours apart, and I'm back to a normal 12 hour/pill schedule today.

Still seeing the bright black dot when I look in the extreme upper-left corner of my eye range, and still with just my right eye. Still soreness when moving my eye in that range. Neither of the doctors seemed concerned about that black dot - like, at all. I woke up today with some crusting in my left eye, which is new, but not a huge issue as I imagine if it's a secondary infection it's about to get killed anyway. If it gets worse, I'll let them know.

Freyland wrote: ↑Wed Sep 12, 2018 2:09 pm Thanks for the update and the feedback, Paingod. I'm a worry-wart, but I'm not there, so I am going assume you are in good hands. That said, if things worsen I would nudge them towards an orbital CT, which is not at all out of the question.

Paingod wrote: ↑Fri Sep 14, 2018 7:21 am I did end up taking to the first doctor about the eye crustiness, and he assumed the antibiotics would deal with whatever it was. It hasn't returned.

This is what I just sent to the two doctors that have seen me so far:

I’m not sure how quickly the antibiotics are supposed to take effect. I’ve been on them since Tuesday (with the “jump start” of two doses 5 hours apart) and the swelling in my eye has only increased. Going into the weekend, I wasn’t sure if I needed to be checked again, if an x-ray or scan should be done to see what the source is, or if I should wait it out and hope the antibiotics will kick in.

The other symptoms – the bright black dot when looking up/left, soreness when looking up in any direction, and feeling of constant pressure have not lessened. Yesterday I experienced something new, though. For a brief moment on my drive home – less than a couple minutes – I felt a sharp stinging sensation, inside the soft tissue over my right eye – inside, above my eye, not outside on the skin. The feeling hasn’t returned.

*Edit: While I was away from my desk, the two doctors had a conversation with me CC'd and they've decided to send me to a hospital for a consult with one of their colleagues there - maybe some blood work, maybe some IV antibiotics if the blood work shows anything alarming. She dropped the MRSA acronym, as in "We don't want to wait on this if it's..."

Waiting to hear back on that. Awesome. I may end up being admitted to a hospital for this.

**Edit: My lack of a PCP is complicating it as I need a referral if I need an MRI. In the last 23 years, I've never had a real PCP. I picked a name out of a hat once when an HR person made me do it 10 years ago, but that was three jobs and three insurance plans ago and I never saw them for anything. Thankfully, my co-workers (being doctors) are looking at getting me a quick PCP that can rubber-stamp whatever they need me to do.

Freyland wrote: ↑Fri Sep 14, 2018 9:50 amFinally, for clarification, after I have been rereading things-- peri-orbital and orbital cellulitis both refer to infections of or immediately around the eyeball. Pre-septal cellulitis is what they keep insisting your diagnosis is, which is a more superficial infection in the front of the eye socket. The latter is easier to treat, the former is bad mojo, and important to address promptly to avoid vision loss and possibly that pesky death thing. Which brings us full circle to me being a worry-wart in your honor.

Paingod wrote: ↑Fri Sep 14, 2018 1:56 pm The results of the CT scan are in. The doctor explained it to me as this...

No signs of orbital cellulitis or abscesses. Sinuses and glands on the CT scan looked clear. The superior rectus muscle of the eye is swollen or thickened. She wasn't sure why I'd have eyelid edema and it wouldn't be common with this issue, but she figures that there may be something that antibiotics killed and the muscle hasn't calmed down yet. She says this rules out this being an emergency situation - unless something unsual happens over the weekend, like my eye continues to swell or closes. She did ask if I've got thyroid issues, which I don't - or am not aware of. She said that as an extreme outlier, it may be orbital lymphoma.

I need to find a PCP next week and get my blood work done to rule out thyroid issues before any more guessing is done. I'll finish the course of antibiotics I'm on, but it doesn't look like there's a lingering infection right now.

So...

Freyland wrote: ↑Fri Sep 14, 2018 4:23 pm Thanks for the update. So my thoughts/explanations, if you will have them:

1) No abscess--> Yay!
2) Chronic thyroid issues can cause the build-up of myxedema of the eye muscles, which can in turn cause the eyes to bulge. That said, one muscle involvement, associated with infectious symptoms, seems like this is unlikely. Not saying dont get the labs, just reviewing your situation with info at hand.
3) Orbital lymphoma? As she stated, extreme outlier (especially with normal surrounding glands, but even without that detail, extreme outlier).
4) So, where my opinion on things differ is the severity of your infectious situation. The swollen muscle on the CT attaches to, and runs adjacent to, the eyeball. This is exactly the region of "Peri-orbital" (not pre-septal) cellulitis. She and I agree that your findings are better than they could be due to the previous oral antibiotic use. We differ because I see you as a partially-treated peri-orbital cellulitis and she (seems) to view you as a partially treated pre-septal cellulitis.

So, where does that leave you? Of course, follow the directions you were given and take the abx your were given. Would suggest careful follow up, and exactly as she said, if you have worsened symptoms of eye pain with movement, eye swelling, eye paralysis, vision worsening then ER is absolutely appropriate. I would argue that fever and/or headache would justify ER as well, based on the concerns I have given you. Keep us informed, and I hope to hear things are getting better!

Still swollen, but maybe not as bad. Still seeing the black dot. Still no discharge. Almost no discomfort, and far less pain when looking up, but that could be that the docs got me on ibuprofen and it may be hiding it? I've got a follow-up with the doctor this morning.

Eye comparison, Friday to Today. Still going on antibiotics, plus 800mg ibuprofen 3 times per day since Friday evening.

Spoiler:

*Edit: Saw the doctor today. Advised to continue antibiotics and 800mg 3x/day ibuprofen until antibiotics run out (maybe 4 days). They did take a snapshot of the inside of my eye and said the nerves looked good and the doc saw nothing wrong in there. A second doctor in the office that viewed my CT results said it "absolutely" ruled out orbital cellulitis... but then the consensus was that they didn't really know what was/is wrong and blood work is in order. For that, I need a PCP - which I don't have. So I'll hunt for one today.

As always, my end hope is that you just *get better* and be done with it, but I am going to exercise my Freydom (you're welcome, Hepcat) to beat a dead equine and again point out I cannot reconcile a swollen ocular muscle found while evaluating an infected eye as anything other than partially treated Orbital cellulitis. Regardless, if everything goes away by the time you finish your antibiotics, huzzah. If symptoms return in the next couple of days thereafter, or never go away completely and begin to worsen, I'm going to start ringing the IV antibiotics bell (whatever that is).

Freyland wrote: ↑Mon Sep 17, 2018 12:03 pmAs always, my end hope is that you just *get better* and be done with it, but I am going to exercise my Freydom (you're welcome, Hepcat) to beat a dead equine and again point out I cannot reconcile a swollen ocular muscle found while evaluating an infected eye as anything other than partially treated Orbital cellulitis.

I appreciate the concern, as always.

I've discovered why I didn't have a PCP. Navigating the labyrinth of Aetna's website to find a provider is a nightmare. Honestly, the eye infection has been more enjoyable. After sifting through and finding some real good docs with good reviews, and calling their offices to schedule an appointment, only to discover that they're not accepting new patients - I gave up and let one office transfer me to another I had no info on and ended up with an appointment to see a Nurse Practitioner working with a Resident reporting to a Doctor. It feels inadequate, but at this point I think I just need a rubber stamp on some blood work to rule out the thyroid and lymphoma concerns so we can get back to refusing to call it an infection.

You know the advantage of a teaching clinic? They like to teach (generally).
You're in a position to spell out the various concerns and the guy the Resident has to report to might be more inclined to take a hand in your case (read: see things my way )

My wife has no sense of smell it seems. I came into the bedroom from the kitchen and instantly smell a strong odor or melting burning plastic. Its so strong as to make me sick and dry my mouth out. She smells nothing. Its making me sick. Its the tv. Something in it is stinking and hot. I blew it out with air but it still stinks. I bet its on its last legs.

Paingod wrote: ↑Mon Sep 17, 2018 12:28 pm

Freyland wrote: ↑Mon Sep 17, 2018 12:03 pmAs always, my end hope is that you just *get better* and be done with it, but I am going to exercise my Freydom (you're welcome, Hepcat) to beat a dead equine and again point out I cannot reconcile a swollen ocular muscle found while evaluating an infected eye as anything other than partially treated Orbital cellulitis.

I appreciate the concern, as always.

I've discovered why I didn't have a PCP. Navigating the labyrinth of Aetna's website to find a provider is a nightmare. Honestly, the eye infection has been more enjoyable. After sifting through and finding some real good docs with good reviews, and calling their offices to schedule an appointment, only to discover that they're not accepting new patients - I gave up and let one office transfer me to another I had no info on and ended up with an appointment to see a Nurse Practitioner working with a Resident reporting to a Doctor. It feels inadequate, but at this point I think I just need a rubber stamp on some blood work to rule out the thyroid and lymphoma concerns so we can get back to refusing to call it an infection.

Call Aetna/HR and them that the provider listed with an open panel on their website refused to see you because they said they weren't taking new Aetna patients. They're trying to foist you off on an NP. Not that there's anything wrong with an NP but the office gets to pay them substantially less.

Daehawk wrote: ↑Mon Sep 17, 2018 2:25 pm My wife has no sense of smell it seems. I came into the bedroom from the kitchen and instantly smell a strong odor or melting burning plastic. Its so strong as to make me sick and dry my mouth out. She smells nothing. Its making me sick. Its the tv. Something in it is stinking and hot. I blew it out with air but it still stinks. I bet its on its last legs.

When electronics are on fire, we don't call it "Last Legs" - we call it "Toast"

Paingod wrote: ↑Mon Sep 17, 2018 2:54 pm

Daehawk wrote: ↑Mon Sep 17, 2018 2:25 pm My wife has no sense of smell it seems. I came into the bedroom from the kitchen and instantly smell a strong odor or melting burning plastic. Its so strong as to make me sick and dry my mouth out. She smells nothing. Its making me sick. Its the tv. Something in it is stinking and hot. I blew it out with air but it still stinks. I bet its on its last legs.

When electronics are on fire, we don't call it "Last Legs" - we call it "Toast"

Did you check it for bagels?

LawBeefaroni wrote: ↑Mon Sep 17, 2018 3:07 pm

Paingod wrote: ↑Mon Sep 17, 2018 2:54 pm

Daehawk wrote: ↑Mon Sep 17, 2018 2:25 pm My wife has no sense of smell it seems. I came into the bedroom from the kitchen and instantly smell a strong odor or melting burning plastic. Its so strong as to make me sick and dry my mouth out. She smells nothing. Its making me sick. Its the tv. Something in it is stinking and hot. I blew it out with air but it still stinks. I bet its on its last legs.

When electronics are on fire, we don't call it "Last Legs" - we call it "Toast"

Did you check it for bagels?

I laughed. It was especially appropriate because I'd just caught up reading the other thread. So it was on my mind too.

Homemade buttermilk pie is in the oven baking as I type this.

Daehawk wrote: ↑Mon Sep 17, 2018 5:19 pm Homemade buttermilk pie is in the oven baking as I type this.

There's a thread to post your pictures of this.

No pic, no happening.

1:00 to go.

I have no idea what a buttermilk pie is but now I believe it exists and I would eat it.

I need new glasses.

Made an appointment at the eye doctor only to discover I can't find my insurance card.

No problem - Providence has a website! Except I don't have an account setup yet and can't create one without my member number which is on the insurance card I don't have.

No problem - I'll talk to HR. They can't access our member numbers and direct me to call Providence.

I call Providence and they can't provide my Member number nor will they assist me with getting access to the website without my member number - which I can't get until I either get an insurance card or login to the website.


Single payer now, please.


HR was at least able to order a new insurance card which I should have in 7-10 days. I guess I'd better be very careful not to get hurt until it arrives because despite paying premiums all year I"m effectively uninsured until it arrives!

Really? Generally they can give you access to the membership number provided you give them SSN and something else.

Z-Corn wrote: ↑Mon Sep 17, 2018 6:59 pm I have no idea what a buttermilk pie is but now I believe it exists and I would eat it.

I'd never heard of it either. It sounds like a Southern thing, but I wonder if it's a Daehawk thing.

Never heard of buttermilk pie, FWIW. Born and raised Deep Fried Southern.

Buttermilk biscuits? Check
Straight up buttermilk? Check (and blech)
Buttermilk cornbread? Check, I make it regularly.

Buttermilk pie sounds interesting (and definitely looks good in the oven pic), but buttermilk ice cream sounds straight up narsty. Buttermilk is literally spoiled milk, so “spoiled milk” flavored ice cream? Pass!

I had to look it up.

Buttermilk is the liquid remains after making butter.
"True" buttermilk is the same liquid above, fermented.

GreenGoo wrote: ↑Mon Sep 17, 2018 11:45 pm I had to look it up.

Buttermilk is the liquid remains after making butter.
"True" buttermilk is the same liquid above, fermented.

Traditional buttermilk is the liquid byproduct from churning butter. Cultured buttermilk is fermented milk, not fermented "traditional buttermilk" (if that is what you meant by "the same liquid above"). In a pinch, fake buttermilk can be made by adding acid (e.g. lemon juice) to regular milk and letting it curdle.

Cheese, yogurt, kefir and sour cream are all "spoiled milk" to the same extent as cultured buttermilk, and they're all delicious, so while I've never had buttermilk ice cream I'd certainly be willing to give it a try.

Internet says what the internet says.

Now I know all that I ever want to about the drainage left over from making butter.

GreenGoo wrote: ↑Tue Sep 18, 2018 1:25 am Internet says what the internet says.

Now I know all that I ever want to about the drainage left over from making butter.

That's why I try to hang out in the classier parts of the internet.

A Definition
Buttermilk is the low-fat portion of milk or cream remaining after it has been churned to make butter. Today, buttermilk is not a byproduct of butter-making, but is made from nonfat or low-fat milk that is “cultured” with lactic acid bacteria. Cultured buttermilk is low in fat and calories, but maintains its traditional tangy flavor and creamy texture.

The Facts
Buttermilk was originally produced while making butter. The milk would often be slightly soured by naturally occurring bacteria before and during churning, giving the remaining butter-flecked liquid a rich, tangy flavor that was naturally full of nutrients. Rather than discard the buttermilk, dairy farms used it for drinking, leavening bread and for baked goods. The acid in buttermilk creates a rich, tangy flavor and tender crumb that is often preferred to commercial baking powder by many bakers today.

The Process
Buttermilk is made from pasteurized nonfat or low-fat milk to which a culture of Streptococcus lactis is added in order to produce acid that thickens and flavors the buttermilk. A culture of Leuconostoc citrovorum can be added to enhance the butter flavor (diacetyl). Butter flakes, salt or citric acid may also be added for flavor. Most buttermilk in the market contains 1or 2 percent milkfat or the same fat content as the milk from which it is made.

I've actually gone looking for "traditional" buttermilk to see how it compares to cultured buttermilk, but I've yet to find a grocery store that sells it. One of these days I guess I'll have to try my hand at making butter and see what I can do with the leftover butter squeezings.

Buttermilk.

You can never know enough about it.

My house has an attic. The entrance is a push-up roof hatch in my hallway. In the 15+ years I've been here, we've never been up there. There was some discussion of it last night, so today I decided to see if the hatch was blocked. I grabbed a stick and gave the hatch a light push. It opened easily, less than an inch, for less than a second. In that time, a 3/4" brown recluse clambered out and dropped at my feet.

Fuck the attic.

Max Peck wrote: ↑Tue Sep 18, 2018 10:33 am I've actually gone looking for "traditional" buttermilk to see how it compares to cultured buttermilk, but I've yet to find a grocery store that sells it.

I've looked too with no luck.

I LOVE buttermilk.

Same. I found some farm online that sold it. But with shipping it was nearly $40 so passed.

Daehawk wrote: ↑Tue Sep 18, 2018 1:35 pm Same. I found some farm online that sold it. But with shipping it was nearly $40 so passed.

Got a link?

Been a while but Ill look. Its just googling real buttermilk.

EDIT: Cant even find it. been years. But I recall it was somewhere up north and had 'farm' in the name. yes very helpful I know lol.

Looking now its no easier though it may be cheaper. But again you need to read closely as 'real buttermilk' is still a lot of times listed as cultured just like in stores. Honestly Im not sure now what constitutes real over cultured.