Nurse Nat

12/16/2025

https://invisibleillness.crowdicity.com/hubbub/communitypage/23445?

12/16/2025

https://www.youtube.com/live/U3ilMz3Y0J4?si=2pg8H2WZBTRd3kX8

Secretary Kennedy Convenes Lyme Disease Patients and Providers to Announce New Diagnostic Efforts--U.S. Department of Health and Human Services (HHS) | http:...

12/12/2025

https://www.lymedisease.org/hhs-lyme-roundtable-dec15/?brid=dfe8Ya6y0dLglz3G-a1Ppg&sfnsn=mo&fbclid=IwZnRzaAOoafJleHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEeIV0ImUNsgEIEIvXsQsNNQXId_2W4onjtHSUZaP85TAcC2xYB-gGh4lS6al4_aem_V9vvxz5azXFWcXrhZwciLQ

The U.S. Department of Health and Human Services (HHS) has announced a roundtable discussion titled Invisible Illness — Leading the Way with Lyme Disease,

12/10/2025

Bartonella and Long Covid. I personsllu think all long haulers should be tested for Lyme, and Co-infections.
https://pub med.ncbi.nlm.nih.gov/38472519/

The diagnosis of long COVID often relies on symptoms post-COVID-19, occasionally lacking biological evidence. This case study illustrates how investigating long COVID uncovered an underlying bartonellosis through clinical metagenomics. Following mild COVID-19, a 26-year-old woman experienced persist...

12/04/2025

Sinusitis is the inflammation or swelling of the tissue lining the sinuses, often caused by infection, allergies, or irritation, leading to symptoms like nasal congestion, facial pain, and pressure.

12/04/2025

The Thyroid Gland — Easy to Understand

1. What is the thyroid gland?
• The thyroid is a major endocrine gland located in the front of the neck, just in front of the trachea.
• It has two lobes connected by a thin bridge called the isthmus.

2. How does the thyroid make hormones?

Step 1: Inside the gland
• The thyroid contains tiny round units called follicles.
• These follicles are filled with a thick fluid called colloid, where hormone production happens.

Step 2: TSH stimulates the thyroid
• The pituitary gland releases TSH (Thyroid-Stimulating Hormone).
• TSH binds to receptors on thyroid cells and tells the gland to:
✔ take up iodine (I⁻) from blood
✔ start making thyroid hormones

📌 Iodine comes mainly from diet (e.g., iodized salt, seafood).

Step 3: Making thyroid hormones
• Iodine binds to a protein called thyroglobulin inside the colloid.
• From this process, two important thyroid hormones are produced:
• T3 (triiodothyronine)
• T4 (thyroxine or tetraiodothyronine)

3. T3 vs T4 — What’s the difference?

✔ T4 (thyroxine)
• Produced in larger amounts by the thyroid.
• Mostly a storage form.
• Later converted into T3 in organs like the liver.

✔ T3
• The active hormone—much stronger effect than T4.
• Only small amounts are made directly by the thyroid.

4. Free vs Bound Thyroid Hormone (High-yield)
• >99% of T3 and T4 in blood are bound to proteins—mainly TBG (Thyroid-Binding Globulin).
•

12/04/2025

❇️ Pheochromocytoma Points to Remember:
→ Tumor of chromaffin cells (neuroendocrine cells) of the adrenal medulla
→ Secretes catecholamines (mostly norepinephrine, sometimes epinephrine, rarely dopamine)

✔️ Rule of 10s
→ 10% bilateral
→ 10% extra-adrenal (paragangliomas)
→ 10% malignant
→ 10% pediatric
→ 10% familial (but actually up to 40% are hereditary)

✔️ Associated Syndromes (Autosomal Dominant)
→ MEN 2A & 2B
→ Von Hippel-Lindau (VHL)
→ Neurofibromatosis type 1 (NF1)

✔️ Clinical Presentation
🛑 Classic triad
→ Episodic headache
→ Sweating (diaphoresis)
→ Palpitations/tachycardia

🩺 Other signs
→ Hypertension (sustained or paroxysmal)
→ Anxiety, tremors, weight loss
→ Orthostatic hypotension (due to volume depletion)
→ Hyperglycemia (catecholamines inhibit insulin)

✔️ Diagnosis

Initial test (high-yield):
→ Plasma free metanephrines or 24-hr urinary catecholamines/metanephrines

Confirmatory test:
→ Clonidine suppression test (in special cases)

Imaging:
→ CT/MRI of abdomen (for adrenal mass)
→ MIBG scan if extra-adrenal or metastatic

✔️ Treatment

Preoperative medical management:
→ α-blocker first: Phenoxybenzamine (non-selective, irreversible)
→ Then β-blocker: Propranolol or atenolol (to control tachycardia)
❗ Never give β-blocker first → unopposed α-vasoconstriction → hypertensive crisis

Definitive:
→ Surgical resection

✔️ Complications
→ Hypertensive crisis
→ Arrhythmias
→ Cardiomyopathy (catecholamine-induced)

12/03/2025

❇️ Skin Colour Warning Signs:

Cyanosis – Bluish or purplish discoloration of skin caused by low oxygen levels in the blood. Often seen in respiratory diseases, heart failure, shock, or severe cold exposure.

Pallor – Abnormally pale skin resulting from reduced blood flow or low hemoglobin (anemia). Also seen in blood loss, shock, and peripheral vasoconstriction.

Jaundice – Yellow discoloration of the skin and eyes due to elevated bilirubin levels. Common in liver disease, bile duct obstruction, hepatitis, hemolysis.

Ecchymosis – Dark purple or bluish patches caused by bleeding under the skin. Often due to trauma, blood-thinning medications, clotting disorders, or platelet abnormalities.

Erythema – Redness of the skin caused by increased blood flow during inflammation, infection, allergies, or heat exposure. May indicate an ongoing inflammatory process.

12/03/2025

Dr Sabine Hazan, Doctor and Gastroenterologist of over 30 years is an expert on the gut microbiome. She has conducted over 200 clinical research trials. Her ...