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thats where peoples personalities come into play.

Just a simple fact- i excercise almost no moderation in anything- its good and bad.

If i enjoy something- im passionate/way into it/consume too much.

Thats likely why i havent come around or been as successful as id like methinks.

its just the way im wired since i was a kid.

People see it as 'passionate' or 'extreme' or 'high energy' in the ways it manifests itself in my day to day- but i think it likely plays a role in the consumption end of things for me also.

Seth, I'm the exact same way

Thats likely why i havent come around or been as successful as id like methinks.


- meaning with curbing the binging until recently, (and I realize that 18 on a Sunday is still binging- but its down from the 12 at least, 5 or 6 days a wk from the past, thats what i mean).

Yeah, i kinda can see (sorry man, you wont like this) some of "me" in you (quiet NEAG) in the way you talk about music or the phils specifically- you are way in- like, levels upon levels into both- and if im into something, im all in as well.

No Seth, I see the same thing, too.

Do you get really interested in something, either learn all you can or try to in a relatively quick period, then tire of it?

What ya gotta do is do some good coke and then you can drink all night.

Jules, seriously... I can't thank you enough for taking the time to read these scenarios, consider them and provide a well thought out response. You are a straight shooter as well and I appreciate that.

I had this bomb dropped on me, I discussed it with the cardiologist the best I could but my head was spinning when I left the office. Then I had time to process and had more questions. I needed to bounce the information I just learned and my thoughts about it off of another qualified party. It's priceless being able to do that without having to schedule an appointment. This is where you provide unbelievable service to this community.

I can't thank you enough sir, you put my mind at ease and hit on some of the things I suspected and couldn't challenge the cardiologist with at the time. You've convinced me that I need to seek a second opinion and I'm in the process of finding the right person for the job. I've gotten some great referrals.

If it turns out that I'm limited to only 2 beers a day, I'd gladly share one with you sir, just so I could salute you.

Thanks again.

If it turns out that I'm limited to only 2 beers a day, I'd gladly share one with you sir, just so I could salute you.

Let's not get crazy here!

Don't worry, it's just the Vicodin talkin'.

Thank science.

I actually don't like telling patients ALL the possible causes of a problem. I feel that that is generally overwhelming and serves no purpose other than to create disproportionate concern. If I suspect it is bad, then it will be easy to demonstrate and I am usually noncommittal avoiding phrases like "it's nothing or I doubt it's anything". Generally, the main thing I don't like about NPs is that there true fund of knowledge is limited. The difference between a good doc and a great one is that the latter will know when he's out of his element and understands the overlap of his specialty as it interfaces with others. NPs lack the latter, since they often have 2 years of training and then jump right into a person's practice. Comparatively, I've done 4 years medical training and then 6 years of specialty training PLUS another year of fellowship (more intense, focused) training. That's not to say they aren't good, just that their capacity is limited by knowledge/experience not intelligence.

Anyway, I hope everything turns out to be a big nothing, Johnson, and I'm happy I could help. And you wanted to shut this site down? I'll tell you to keep the second beer so long as the "virtual bar" stays open so we mopes can talk about everything from McNabb, to Spud's undeclared homosexuality, to G Cobb's scoops, to legalizing marijuana, to Obama to croc-filled moats. Salud!

Doc,

Is there any cure for a bent penis?

I'm at about one o'clock these days.

hehe...its called Peyronies disease.....either you live with it OR you get the scar tissue that is giving your thingey a little english on your stick removed....however, for the latter, you lose length.

No great choices......sorry

Hey Jules-


I need your opinion on something- i have a girlfriend who is having some problems, but I don't want to spill all her personal shit out here. Any way we can exchange email thru the site? Normally I'd just say, "call Obama", but she lives in socialist England, and is having problems seeing a real doc

Sure, FB, Johnson/Hooky/Uber all have my email addy. They could pass it along to you.

Hey Jules,

Hopefully this is a quickie for you. On Saturday, I noticed some pain in my left elbow. Didn't think much of it. Came back from a party on Friday night, and the thing had swollen up weirdly. Didn't go away on Sunday, and the pain seemed a bit worse. Today seems about the same.

Looked it up on the web, and it would seem to be olecranon bursitis from all my symptoms. Questions to you are this:

A. Could this be caused by a super minor bump on the elbow, because I really don't remember whacking it good anytime on Saturday, and I don't see any bite marks around it that would indicate an insect bite

B. Is there really anything I can do for it other than Advil? I'm out of town, and won't be back until the weekend, and really don't feel like going to the ER to have this looked at. If it's still around next week, I can go to my regular doc. Would it be any problem to wait that long to have it looked at? Doesn't sound like it can get any worse.

Gotta say this is the weirdest thing. Elbow just started hurting out of the blue, then swells up. Tres etrange.

Not sure, Sarge.

The tricky part for me is knowing whether the swelling is more centered in superficial tissues or the joint space itself. If your "elbow" looks swollen, that is one thing. If it is superficial, then it may either be related to a bursitis (inflammation of a bursal sac) OR a focal cellulitis from an insect bite or whatever.

I'm betting it is a bursal sac inflammation. If it accumulates fluid (regardless of what the cause is) it'll hurt and be noticeably swollen. Advil will help.

The important thing is if it looks red/inflammed or if you have compromised motion of your elbow. Those are ER issues and you'd need to get checked out. The former could be from an infection and the latter would be confusing. Did you have any penetrating trauma (cue laughter) from a needle or splinter or scratch skin.

U don't feel sick do you? Recent new medications?

BTW, if you feel the region of swelling does it feel like a contained region that you can feel under the skin? Sac like? If that is the case it is MOST likely bursal from the description you give. Advil and the tincture of time.

Jules,

Thanks for the quick reply. It is reddish with swelling, but there's no compromise of motion whatsoever. Just some dull pain there. I looked all around the area, and didn't see an insect bite at all. It seems to be a little less swollen today than it was yesterday. Definitely had the Popeye look going on yesterday. Advil has definitely been helping with the pain.

The region underneath felt like there was some kind of small, elongated sac that I could kind of mush and press around, but then there was swelling above that area too, i.e. the sac wasn't pressed up against the skin. There was swelling between the item and the skin.

If you still have problems tomorrow, I'd see if you can get to see someone in an urgent care clinic. I think this is probably related to either a superficial infection or inflammation of a bursal sac.

LMK what happens....hopefully its limited and pain free going forward.

What you describe is localized and most likely bursal. It will feel like a sac of fluid under the skin and not attached to it as you are describing it.

Hey Jules,

Seems to be a lot better today. Much less swelling, but still some noticed some redness. Thanks for the help.

What's really weird about the whole thing is it just popped up out of nowhere. I was working on the car replacing my rear brake pads during the day, but never remembered whacking that part of my arm/elbow.

Guess I'm just surprised that something like this could happen either from no blow to the elbow, or such a small one that it went unnoticed. I would think you'd have to whack your funny bone good to get this to happen.

Well, if you were doing activities you usually don't, you can easily irritate a bursal sac, ie working on the car isn't something you normally do (maybe I'm wrong here). The older you get, the easier it is to do that. Not saying you are long in the tooth. I'm just saying it is more frequent, especially after clearing 30.

Glad to hear things are easing up.

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