Dr. Amy Chai, MD

Radiation treatment is not painful. But it does cause a lot of fatigue. Also there can be some side effects down the road a few years later. Best wishes

This is not the sort of problem that can be solved by the emergency room. I would go to the Internal Medicine doctor and begin getting evaluated properly. You may need some blood tests and follow up. The ER will pretty much just try to figure out if you are getting ready to die today, and if you aren't, they will just send you back to the primary care doctor. With your many symptoms, you may end up needing a referral to a specialist. But start with primary care. When you say flu-like symptoms and fatigue that started BEFORE you got covid, I am thinking first of something like "Chronic Fatigue Immune Deficiency Syndrome." (CFIDS). Then if you got covid on top of that, you could be feeling worse. Vertigo is common after viral infections, too. But this is totally impossible to diagnose without the proper evaluation, so I definitely think you need to see your PCP. Good luck.

No. Scoliosis does not impact life expectancy. It can cause problems with back pain over time, so I always suggest being careful about posture, lifting, exercise, stretching, and the like. Make sure your work environment has good ergonomics.

Persistent nerve pain in the back (assuming you already have been checked by your doctor and tried the physical therapy or other treatment prescribed by your doctor) is best treated by an orthopedic/anesthesiology physician who does injections and pain medicine therapy.

The best drink to help with constipation is plain water. Constipation is made worse by dehydration. Our "high fiber" foods become slow moving clogs without adequate water. So, keeping hydrated with adequate water is very important to help prevent constipation. Another good drink for constipation is coffee. It can have the effect of stimulating the colon. Also, drinking
coffee is good for the liver, and it may help reduce the risk of diabetes. So, my answer is water and coffee. The effect of "prune juice" is mostly due to its fiber content. A fiber supplement with water added can have this same effect.

Most foods have sugar in them. Carrots, potato, bread, apples, pasta, lentils, well, everything except plain meat has sugar in it. Diabetics need to be particularly in tune to the TYPE of sugar in the food. Some sugars are hard to digest, like fiber found in whole grains like oatmeal. Some sugars are easy to digest, like white rice and table sugar. You cannot live without sugar, but you can live without processed foods. Processed foods take all the fiber and complex sugars out (carbohydrates) and replace them with refined sugars (white flour, white rice, sweets, etc.). If you were just diagnosed with diabetes at 45 years old, chances are good that you have "type 2" diabetes. When you eat carbohydrates, glucose goes into your blood. If you eat natural carbohydrates like plain oatmeal, the glucose goes up slowly and does not cause a big sugar spike or insulin spike. If you eat processed carbohydrates like desserts or sweetened beverages or fruit juice, the glucose will rise very fast and high into the blood. This causes the insulin to spike, and the blood sugar to rise. It is a very short explanation of a very long subject. You might want to google "low glycemic index foods" and "the American Diabetes Association (ADA) for more information.

We do know that concussions and closed head injuries can have long-term repercussions, especially repeated head injuries of the sort that often occur in certain types of sports. But if the baby checked out fine and did not have a concussion or other serious injury, I would not worry. Kids will often get the "goose egg" injury from a bump on the head and have no long lasting effects. Permanent problems from head trauma depend on the severity and the location of the injury, which should not be surprising. However, if you feel that the baby is not making developmental milestones, I would certainly have her checked out by a pediatrician.

The sudden onset of urinary incontinence is concerning and should warrant a call to your doctor right away. However, urinary incontinence has not been associated with covid-19 in any of the symptom notifications put out by our health department. Of course, severe coughing can sometimes cause incontinence, and cough is definitely a covid-19 symptom. So if you have developed sudden incontinence, call your physician.

Typically, pus anywhere will require antibiotic treatment. If pus is DRAINING from the ear, it can mean a ruptured eardrum or a foreign body in the ear. Of course, this means he should get this evaluated by his doctor.

If your testicular area is enlarging, you will need to get an examination by your doctor. It could be anything from a hernia to a testicular cancer.

That would be unlikely. I would follow up with your gynecologist.

I assume you mean a rapid, unintentional twitch of the eyelid? That is called, blepharospasm. It is a localized muscle dystonia that could be due to fatigue, on the computer too long, or just plain short out of the part of the brain that switches muscle off n on. You can treat it with botox if it does not simply go away after a bit of rest.

IBS is a chronic condition that can be managed. It is not a “harmful” condition, although symptoms can be hard to deal with. Depression can cause this type of functional illness. IBS is associated with a childhood history of emotional, physical, or sexual abuse. This does not mean that this is the cause in your son, but it does mean that a good therapist will help and will also help to prevent him from “catastrophizing” his symptoms, and will help bring up anything your child might not be sharing with you. In short, IBS is not a serious illness and you should not condition your son to fear it. He may have lifelong symptoms, but they are treatable. He needs a mental health therapist to help him deal with symptoms and to determine if there is an underlying depression, anxiety, or abuse history.

It is not unusual for viral infections such as bronchitis to last 3 weeks. However, by that time it should be mostly improved. If he is not improved, he should be evaluated.

I would simply like to make sure you have been evaluated by a neurologist. As a primary care doctor, I would hesitate to make this diagnosis without being sure other causes were ruled out. Caffeine is actually a common treatment for this type of headache, also indocun or lithium might be used. But I suggest getting your treatment from the diagnosing physician.

Tendons attach muscles to bones. A "strain" is a pulled or torn tendon. Ligaments attach bones to other bones. A "sprain" is a pulled or torn ligament. Tendons (and ligaments) are not calcified like bones are, so of course you cannot see them on an X-ray, unless the tear is so bad that it pulled off a piece of bone along with it. So, how can you tell if they are torn? Well, often we can tell if a tendon is torn "all the way through" by the physical exam. The muscle will be balled up and it won't work at all because it is pulled off of the bone. Often, if there is a partial tear of a tendon, it is hard to tell how bad it is. Normally, we just rest, ice, and do physical therapy. Most of the time it will heal up in a few weeks. If it doesn't, then it might be time to look at it with an MRI. If the tendon is really obviously torn on exam, or if it pulled a bone chip off on X-ray, then we would go ahead and send the patient to orthopedics or get an MRI right away. So, it depends on how severe the tear is, what muscle is involved, and whether or not it is likely to heal on its own versus getting sent to orthopedics. The MRI part is mostly if we are thinking about surgery in this case.

Before you can discover the correct treatment for your neck pain, it is important to know the cause of the pain. It can be any number of diagnoses, including a strain, spondylosis, pinched nerve, muscle spasm, or even infection. You will need to be evaluated by your doctor to find answers. Often, physical therapy is a starting point for common causes of neck pain.

This is a great question. Of course, you should be calling your primary care doctor to see if you can get in right away. However, if you are anything like most men your age, you don't HAVE a primary care doctor. Maybe you called around and the next "new patient visit" is next spring. So you are left to wonder about the seriousness of your back pain. In this case, it is an appropriate first step to go to the ER. They can "check you out" to make sure you do not have any genuinely serious problems. If there is a serious problem, they can send you to the right specialist. If there is NOT a serious problem (most likely scenario) they will refer you to a new primary doctor who can get you on the road to recovery.

Hashimotos thyroiditis is so common that it is the most common cause of hypothyroidism, a condition that pretty much everyone has. Most people don’t bother to diagnose it or “name” it, they just treat it. It is never “cured” but it is super easy to treat. It only requires periodic blood testing, and typically some med adjustment. Don’t believe all the fake news about thyroid madness that you see on the internet. Just get regular follow up with your endocrinologist or PCP.

A blood test is required to diagnose sickle cell anemia. Sickle cell trait is more likely if you are an adult and were never diagnosed with SCD. Sickle disease requires one SCD gene from each parent. However, the typically asymptomatic SC trait requires one normal gene from one parent and one SCD gene from the other parent. Either condition is easily diagnosed with a blood test. Your doctor can order it for you.