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Posted: 3/3/2019 9:51:36 PM EDT
[#1]
Quote HistoryQuoted:
Same-same. Crepitus is a description of what you see/hear/feel. Subcutaneous emphysema is what the air under the skin is called--a diagnosis. For example: The physical finding of crepitus is often observed in the case of subcutaneous emphysema. Quote HistoryQuoted:
Quoted: Similar to subcutaneous emphysema? 
ETA corrected smiley face |
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Posted: 3/3/2019 9:52:51 PM EDT
[#2]
Quote HistoryQuoted:
This. Being in a relationship with someone with BPD is an emotional minefield that you will be lucky to survive with your life, much less your sanity. 
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Posted: 3/3/2019 9:57:01 PM EDT
[#3]
Quote HistoryQuoted: I think if we thought about it, especially we old-timers, we all have been there in one form or another. My ex has bipolar with psychotic features and a delusional disorder. Talking about a nightmare. |
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Posted: 3/3/2019 9:59:10 PM EDT
[#4]
Tag
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Posted: 3/3/2019 9:59:30 PM EDT
[#5]
Quote HistoryQuoted:
I'd only heard crepitus only used in reference to closed fractures. Thanks for the info!
ETA corrected smiley face |
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Posted: 3/3/2019 10:01:13 PM EDT
[#6]
Quote HistoryQuoted: Most definitely. Mental illness of some sorts affects what, 1 in 5 individuals? My ex has bipolar with psychotic features and a delusional disorder. Talking about a nightmare. |
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Posted: 3/3/2019 10:03:31 PM EDT
[#7]
Quote HistoryQuoted: I bet she’s well known to the local ER and I bet she could give us a earful about how docs neglect and don’t believe her. Yes? |
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Posted: 3/3/2019 10:08:26 PM EDT
[#8]
Quote HistoryQuoted: Imagine being a kid with a BP mom. 
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Posted: 3/3/2019 10:08:35 PM EDT
[#9]
Quote HistoryQuoted:
I bet she’s well known to the local ER and I bet she could give us a earful about how docs neglect and don’t believe her. Yes? Quote HistoryQuoted:
Quoted: Most definitely. Mental illness of some sorts affects what, 1 in 5 individuals? My ex has bipolar with psychotic features and a delusional disorder. Talking about a nightmare. |
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Posted: 3/3/2019 10:10:18 PM EDT
[#10]
A bunch of (mostly) PhDs trying to define 'normal' in THEIR terms.
So many of them are already off the curve they can barekly finction among a larger crowd. It takes a differnet drive to get a PhD. I have one. In Electric al Engineering. And like every other Engineer we are 'different.' The far side of the MD declaring the newly born child "An Engineer" and parents being forsaken is not all that far off. We are strange and we damn well know it. There are more lawyers, MBAs, and MDs than Engineers. Especially ifg you look at Professional Engineers. Those of us with an actual State License. Note that MDs kill patients one at a time. An Engineering failure gets a lot of victims all at once. |
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Posted: 3/3/2019 10:10:33 PM EDT
[#11]
Quote HistoryQuoted:
Most definitely. Mental illness of some sorts affects what, 1 in 5 individuals? My ex has bipolar with psychotic features and a delusional disorder. Talking about a nightmare. Quote HistoryQuoted:
Quoted: I think if we thought about it, especially we old-timers, we all have been there in one form or another. My ex has bipolar with psychotic features and a delusional disorder. Talking about a nightmare. It fit her perfectly Profile of the Sociopath Glibness and Superficial Charm. Manipulative and Conning. They never recognize the rights of others and see their self-serving behaviors as permissible. ... Grandiose Sense of Self. ... Pathological Lying. ... Lack of Remorse, Shame or Guilt. ... Shallow Emotions. ... Incapacity for Love. Need for Stimulation. |
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Posted: 3/3/2019 10:11:08 PM EDT
[#12]
Quote HistoryQuoted: Reading stuff like this is a reminder of why I'm hesitant to disclose my PD and bipolar type II diagnosis on intake paperwork. Certainly you recognize the fact that certain disorders do come with obvious negative behavior patterns, yes? |
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Posted: 3/3/2019 10:19:25 PM EDT
[#13]
Quote HistoryQuoted: Certainly people are perfectly functional with the diagnosis, especially if treated. The very fact that you both recognize the diagnosis and recognize the issues that come with it puts you head and shoulders ahead of your peers. Certainly you recognize the fact that certain disorders do come with obvious negative behavior patterns, yes? |
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Posted: 3/3/2019 10:29:05 PM EDT
[#14]
Quote HistoryQuoted:
This. Being in a relationship with someone with BPD is an emotional minefield that you will be lucky to survive with your life, much less your sanity. Edit: I know it sound like I’m speaking hyperbole, but I’m being dead serious. They are toxic monsters that once you see behind their mask, their defense is to destroy you in every way. There’s no bottom to their abuse and no limit to their sadistic control. They can justify any behavior, even outright murder, and claim they are the victims. They can also go from a raging monster to a charming waif, to being physically violent, back to rage, then to crying on the floor about how abusive YOU are, then on to coming on to you sexually then raging, all in the space of ten minutes to ten days. This is usually followed up by what would pass as normal behavior until you bring it up and try to reconcile the behavior or you ‘screw up’ and put the forks in the dishwasher tines down and then the cycle starts all over again. Quote HistoryQuoted:
Quoted:
When a girl mentions she has BPD, or exhibits any if the signs... Run. The. Fuck. Away. They cannot be fixed. BPD destroys everything in it's vicinity. Thanks for the reminder, OP. Seriously. Edit: I know it sound like I’m speaking hyperbole, but I’m being dead serious. They are toxic monsters that once you see behind their mask, their defense is to destroy you in every way. There’s no bottom to their abuse and no limit to their sadistic control. They can justify any behavior, even outright murder, and claim they are the victims. They can also go from a raging monster to a charming waif, to being physically violent, back to rage, then to crying on the floor about how abusive YOU are, then on to coming on to you sexually then raging, all in the space of ten minutes to ten days. This is usually followed up by what would pass as normal behavior until you bring it up and try to reconcile the behavior or you ‘screw up’ and put the forks in the dishwasher tines down and then the cycle starts all over again. Those who have been through it, know. Those who haven't, take heed. |
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Posted: 3/3/2019 10:38:35 PM EDT
[#15]
Thanks for posting OP
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Posted: 3/3/2019 10:38:37 PM EDT
[#16]
Quote HistoryQuoted:
A bunch of (mostly) PhDs trying to define 'normal' in THEIR terms. So many of them are already off the curve they can barekly finction among a larger crowd. It takes a differnet drive to get a PhD. I have one. In Electric al Engineering. And like every other Engineer we are 'different.' The far side of the MD declaring the newly born child "An Engineer" and parents being forsaken is not all that far off. We are strange and we damn well know it. There are more lawyers, MBAs, and MDs than Engineers. Especially ifg you look at Professional Engineers. Those of us with an actual State License. Note that MDs kill patients one at a time. An Engineering failure gets a lot of victims all at once. |
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Posted: 3/3/2019 10:41:47 PM EDT
[#17]
I had a friend who was a little off when we were young by his 30 ‘s his swings were severe. He was diagnosed as bi polar, he took meds for a while that actually made him more or less normal. Got married had a business, etc. he decided ine day he didn’t want to take his meds anymore “the made him fat”. Lost his business, wife, and half his retirement. I had to break ties with him as his bullshit was spilling into my life. 12 years later (this past year) I initiated contact, I miss the friend I used to know. That man is gone. He has developed a gambling problem and was defrauding his church’s poor fund. He looks like a bum that lives under a bridge....they had to shave his head there were so many knots in his hair he hadn’t washed or brushed it for so long. He threatened suicide (veiled threat so you can’t baker act him). This is all within the two weeks I made contact and subsequently cut him out of my life forever. He is a cancer. It is truly a shame our society decided to close the nut houses where people like hime could get help. Sorry for the long post, I guess it is more of a vent. I really wish we could make more headway with treatment of mental illness.
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Posted: 3/3/2019 10:54:39 PM EDT
[#18]
Quote HistoryQuoted: Jesus Christ dude, you described my marrige. I could fill up the entirety of arfcom's servers with my stories, but lets just say that I barely survived. I quite literally, in the truest sense of the phrase, made it out alive. I have the scars to prove it, both physical and emotional. Those who have been through it, know. Those who haven't, take heed. |
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Posted: 3/3/2019 10:58:40 PM EDT
[#19]
Quote HistoryQuoted:
I saw the title, then OP, immediately knew why. That thread was fascinating |
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Posted: 3/3/2019 11:00:56 PM EDT
[#20]
Bpd has destroyed a life I worked so hard to build, my children 3 and 6 can’t understand why we aren’t a family anymore, it’s been two years and I haven’t even gone on a single date. They will give you the highest highs you have ever experienced and the absolute lowest lows, I truly loved my ex at the time but had to except her version of love was not love at all.
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Posted: 3/3/2019 11:01:41 PM EDT
[#21]
I have had close, daily experience with both an NPD and a BPD for an extended period in my life. It has altered what my life could have been had they never been in it. Mental illness is a bitch.
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Posted: 3/3/2019 11:05:59 PM EDT
[#22]
Quote HistoryQuoted: +1 That thread was fascinating |
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Posted: 3/3/2019 11:13:10 PM EDT
[#23]
Quote HistoryQuoted:
Bpd has destroyed a life I worked so hard to build, my children 3 and 6 can’t understand why we aren’t a family anymore, it’s been two years and I haven’t even gone on a single date. They will give you the highest highs you have ever experienced and the absolute lowest lows, I truly loved my ex at the time but had to except her version of love was not love at all. My ex went so far to get help that she volunteered for electronic conclusive therapy. Yes, they still do that. No, it wasnt effective. What sort of mental illness is so powerful that even shocking your brain repeatedly wont work? BPD. It's pure fucking evil. |
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Posted: 3/3/2019 11:24:05 PM EDT
[#24]
Quote HistoryQuoted:
Bpd has destroyed a life I worked so hard to build, my children 3 and 6 can’t understand why we aren’t a family anymore, it’s been two years and I haven’t even gone on a single date. They will give you the highest highs you have ever experienced and the absolute lowest lows, I truly loved my ex at the time but had to except her version of love was not love at all. |
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Posted: 3/3/2019 11:27:13 PM EDT
[#25]
Don't think I've ever met anyone with BPD, or at least knew it. Maybe I'm just lucky?
Hopefully it'll stay that way because it sounds pretty terrible. |
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Posted: 3/3/2019 11:30:17 PM EDT
[#26]
Quote HistoryQuoted: In a sense, I almost feel bad for those with BPD. They'll never know what a baseline "normal" is, short of a lobotomy. My ex went so far to get help that she volunteered for electronic conclusive therapy. Yes, they still do that. No, it wasnt effective. What sort of mental illness is so powerful that even shocking your brain repeatedly wont work? BPD. It's pure fucking evil. Conclusive electric therapy sounds so...final. |
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Posted: 3/3/2019 11:36:34 PM EDT
[#27]
Quote HistoryQuoted: They didn't add "crepitus." Crepitus is a "popcorn" sensation (best I can describe it) under the skin and a cracking/popping sound in the lungs or over a joint. When it comes to skin or subcutaneous crepitus, the cause quite often is entrained air under the skin. I did an exam on a guy once, with chief complaint of low back pain, who had been seen by many other doctors and ER for the same. As I did the physical exam, I noticed that the skin of his left upper arm was "crackly" like crunching down on Styrofoam or plastic bubble wrap. Extend the exam down and I find where he was shooting up. Seems that, if he couldn't get a vein, he'd just inject whatever was in the syringe, air and all, sub-Q. This created a buildup of air under the skin of his upper arm that crackled under palpitation. When confronted with this, the patient left AMA--if you define "AMA" as pushing past the doc, knocking down the nurse, pushing over the Mayo stand, and running out of the facility. Edit: Or maybe it was "pompatus". IDK. |
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Posted: 3/4/2019 1:39:04 AM EDT
[#28]
Quote HistoryQuoted: In a sense, I almost feel bad for those with BPD. They'll never know what a baseline "normal" is, short of a lobotomy. My ex went so far to get help that she volunteered for electronic conclusive therapy. Yes, they still do that. No, it wasnt effective. What sort of mental illness is so powerful that even shocking your brain repeatedly wont work? BPD. It's pure fucking evil. Feel as sorry for them as you would a child molester. |
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Posted: 3/4/2019 1:46:47 AM EDT
[#29]
Quote HistoryQuoted:
Don't think I've ever met anyone with BPD, or at least knew it. Maybe I'm just lucky? Hopefully it'll stay that way because it sounds pretty terrible. If you do find yourself in a relationship with a BPD, odds are you have some issues to work on. Blaming them is easy. Taking a look in the mirror is hard. Get out of the relationship, get professional help, be honest with yourself, work diligently through your own issues and if you are lucky you will only have one BPD relationship in your life. |
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Posted: 3/4/2019 1:56:28 AM EDT
[#30]
Quote HistoryQuoted:
Also consider the whole argument about being ignored and not worked up for the primary complaint and then, when asked how she knew that the fall caused her injury, she said that a pain expert read her MRI and said it was caused by the fall. Well, if she was being ignored, then where did the MRI and Pain expert come from to validate the injury? It is a befuddlement. Quote HistoryQuoted:
Quoted:
I found this part of that thread interesting. I use the words "drop" and "fall" interchangeably, yes. She had me get up and I fell, but I say "dropped" sometimes because it was her responsibility to move me safely and she didn't do that. I know she said all doctors are incompetent, but even my non-MD ass would be ordering a battery of tests. |
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Posted: 3/4/2019 2:02:17 AM EDT
[#31]
She also took a particularly defensive attitude towards @Navydoc1 without knowing his specialty, and assumed he didn’t know a damn thing. Knowing his background and double board status, he is literally one of the best people on this site to ascertain her mental status as well as give an opinion with regards to her mental status. Just saying... he knows his stuff with regards to pain patients.
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Posted: 3/4/2019 2:19:09 AM EDT
[#32]
And Incase anyone doesn’t know@ ISED8U is an anesthesiologist, hence why he couldn’t believe what she was saying about any and all post op procedure. Literally, anyone having a colonoscopy or endoscopy stays on the same bed the entire time. There are 2 transfers, before the procedure when the patient is completely coherent, and they change their clothes, and after the procedure when the nurse asks them to sit in a wheelchair. There is at no point, at any US hospital, where a single, unattended nurse, will ask you to walk to another bed. It just doesn’t happen. The possible consequence is millions of dollars. It just doesn’t happen.
I’ve been on the other side of a malpractice lawsuit for those that think we protect our own. My grandfather had open heart surgery and coded multiple times on the table. As mad as my family was, he only had a 20% chance of survival prior to the operation. He died, yet here I am, a doctor (podiatrist) defending other doctors because stuff happens. If you want to gripe about medical malpractice and the statistics regarding medical treatment it’s easy, don’t seek medical treatment and see what happens. Someone said in a different thread that their goal was to never see a surgeon. That’s my goal as well, but I’m damned sure glad that they exist if I need them, because what is the alternative? |
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Posted: 3/4/2019 2:22:56 AM EDT
[#33]
Quote HistoryQuoted:
I saw the title, then OP, immediately knew why. |
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Posted: 3/4/2019 2:23:16 AM EDT
[#34]
Also, not doxing, but Navydoc1 is a badass pain management specialist also board certified in anesthesiology. So please, don’t assume that the docs of arfcom are tarded.
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Posted: 3/4/2019 2:42:40 AM EDT
[#35]
Quote HistoryQuoted:
She also took a particularly defensive attitude towards @Navydoc1 without knowing his specialty, and assumed he didn’t know a damn thing. Knowing his background and double board status, he is literally one of the best people on this site to ascertain her mental status as well as give an opinion with regards to her mental status. Just saying... he knows his stuff with regards to pain patients. |
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Posted: 3/4/2019 3:17:37 AM EDT
[#36]
Hey Doc what’s the disorder where you are miserably depressed when waking up but are perfectly fine like 10-15minutes after and the rest of the day
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Posted: 3/4/2019 3:25:58 AM EDT
[#37]
Quote HistoryQuoted:
+1 That thread was fascinating Quote HistoryQuoted:
Quoted:
I saw the title, then OP, immediately knew why. That thread was fascinating |
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Posted: 3/4/2019 3:44:55 AM EDT
[#38]
Quote HistoryQuoted:
I only posted the PD that seemed Germaine to the thread in question 
In my med school psych rotation, I recall one of the psych attendings saying, "If you look on tomorrow's schedule and see a particular patient and say, 'Oh crap, there goes my day', and every single person in the clinic says the same thing, there's a good chance that person has a Cluster B personality disorder, BPD until proven otherwise." It was sage advice. |
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Posted: 3/4/2019 4:18:19 AM EDT
[#39]
Interesting stuff, Doc. I always enjoy your posts.
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Posted: 3/4/2019 4:26:36 AM EDT
[#40]
Quote HistoryQuoted:
What thread?? Have a link? Now, I’m curious. Quote HistoryQuoted:
Quoted:
Quoted:
I saw the title, then OP, immediately knew why. That thread was fascinating |
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Posted: 3/4/2019 9:12:42 AM EDT
[#41]
Here's something else for you gentlemen to ponder:
WADDELL's SIGNS Purpose
Waddell's signs were developed to identify psychogenic, or nonorganic, manifestations of pain in patients that may have heightened emotional effects on their conditions. In order for these signs to be significantly correlated with disability, three of the five signs should be present, Waddell et al. in 1980.4 They have been also associated with detecting malingering in patients with complaints of lower back pain. Technique 1. Superficial and Widespread tenderness or Nonanatomic tenderness. (Skin discomfort on light palpation or tenderness crossing over non-anatomical boundaries) 2. Stimulation tests: Axial loading and Pain on simulated rotation. (eliciting pain when pressing down on the top of the patient’s head or rotating the shoulders and pelvis together should not be painful) 3. Distracted straight leg raise. (if a patient complains of pain on straight leg raise, but not if the examiner extends the knee with the patient seated at another time during the initial evaluation) 4. Non-anatomic sensory changes: Regional sensory changes and Regional weakness.(sensory loss in an entire extremity or side of the body or weakness that is nonconsistent and jerky, ie "cogwheeling") 5. Overreaction. (Exaggerated painful response to a stimulus, that is not reproduced when the same stimulus is given later) If there are more than 3 of 5 present then there is high probability that patient has non-organic pain. Evidence |
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Posted: 3/4/2019 9:24:25 AM EDT
[#42]
Quote HistoryQuoted:
https://i.imgur.com/Iu9aeyQ.gif In my med school psych rotation, I recall one of the psych attendings saying, "If you look on tomorrow's schedule and see a particular patient and say, 'Oh crap, there goes my day', and every single person in the clinic says the same thing, there's a good chance that person has a Cluster B personality disorder, BPD until proven otherwise." It was sage advice. In a weird way I’m glad I married a BPD. I was carrying a ton of emotional baggage from my childhood that was really screwing up my life. I had a couple of kids and when I saw their behaviors mimicking mine and my wife’s I loved them too much to allow the cycle to repeat. I humbled myself, talked to people that I knew would tell me the hard truth and started the long journey of dealing with my past. I sought out professional help, changed my thoughts and behaviors, and at 39 I began to love myself for the first time. When I suggested to my BPD wife that she too could get help and make a change in her own life, she began a relentless and systematic destruction of everything I love in life. I tried to stick it out and kept trying to get her to professional help and it seemed to work occasionally, until the therapist asked me to come in too. When I would tell my side of the story, my wife would have a meltdown and start screaming at the threapist. This happened several times. We are separating at the end of the month. I’m getting a 50/50 custody of the kids. She never misses an opportunity to degrade me in front of the kids. Luckily they are old enough to see what she is doing. She doesn’t even realize she is slowly destroying her relationship with them. But destroying relationships is what BPD’s do best. And it will always be someone else’s fault. |
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Posted: 3/4/2019 9:25:50 AM EDT
[#43]
I think my sister has some type of personality disorder.
Either that or just an extremely short fuse. She treats her husband like an asshole for no apparent reason. The other night she took offense to something he said (it wasn't an insult), put on her coat and demanded he drive her home. We were right in the middle o something and couldn't so doing the adult thing shed decided to start walking in the cold. Poor guy, I'll probably sympathize with him when they split up. |
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Posted: 3/4/2019 9:32:22 AM EDT
[#44]
Try being married to a woman who was raised by an NPD mother and she was starting to exhibit the signs herself.
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Posted: 3/4/2019 9:33:56 AM EDT
[#45]
Quote History
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Posted: 3/4/2019 9:34:00 AM EDT
[#46]
Quote HistoryQuoted:
I think my sister has some type of personality disorder. Either that or just an extremely short fuse. She treats her husband like an asshole for no apparent reason. The other night she took offense to something he said (it wasn't an insult), put on her coat and demanded he drive her home. We were right in the middle o something and couldn't so doing the adult thing shed decided to start walking in the cold. Poor guy, I'll probably sympathize with him when they split up.  Attached File |
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Posted: 3/4/2019 9:41:16 AM EDT
[#47]
Quote HistoryQuoted:
Um...I’m not a professional, but if this kind of behavior is common for her, then: /media/mediaFiles/sharedAlbum/TSdKDYc-50.gif Quote HistoryQuoted:
Quoted:
I think my sister has some type of personality disorder. Either that or just an extremely short fuse. She treats her husband like an asshole for no apparent reason. The other night she took offense to something he said (it wasn't an insult), put on her coat and demanded he drive her home. We were right in the middle o something and couldn't so doing the adult thing shed decided to start walking in the cold. Poor guy, I'll probably sympathize with him when they split up. /media/mediaFiles/sharedAlbum/TSdKDYc-50.gif I'm glad it seems to have missed me. Maybe once a year I throw a wrench after smashing my knuckles, but if my wife somehow managed to piss me off in public I wouldn't make a scene of it and then try to walk home like an angsty teenager. |
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Posted: 3/4/2019 9:42:57 AM EDT
[#48]
Quote HistoryQuoted:
Hey Doc what’s the disorder where you are miserably depressed when waking up but are perfectly fine like 10-15minutes after and the rest of the day |
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Posted: 3/4/2019 9:43:06 AM EDT
[#49]
And of course, there is good old Munchausen
What are the symptoms of factitious disorder imposed on self (Munchausen syndrome)?
People with this syndrome deliberately produce or exaggerate symptoms in several ways. They might lie about or fake symptoms, hurt themselves to bring on symptoms, or alter diagnostic tests (such as contaminating a urine sample). Possible warning signs of Munchausen syndrome include the following: Dramatic but inconsistent medical history Unclear symptoms that are not controllable and that become more severe or change once treatment has begun Predictable relapses following improvement in the condition Extensive knowledge of hospitals and/or medical terminology, as well as the textbook descriptions of illnesses Presence of multiple surgical scars Appearance of new or additional symptoms following negative test results Presence of symptoms only when the patient is alone or not being observed (e.g. seizures or passing out) Willingness or eagerness to have medical tests, operations, or other procedures History of seeking treatment at numerous hospitals, clinics, and doctors' offices, possibly even in different cities Reluctance by the patient to allow health care professionals to meet with or talk to family, friends, or prior health care providers Problems with identity and self-esteem More comfortable being in the hospital than you might think Medical knowledge may be quite extensive from many hospitalizations or prior work What are the symptoms of factitious disorder imposed on another?
Certain characteristics are common in a person with FDIA: Often is a parent, usually a mother, but can be the adult child of an elderly patient, spouse or caretaker of a disabled adult Might be a health care professional Is very friendly and cooperative with the health care providers Appears quite concerned (some might seem overly concerned) about the child or designated patient Might also suffer from factitious disorder imposed on self (This is a related disorder in which the caregiver repeatedly acts as if he or she has a physical or mental illness when he or she has caused the symptoms.) Other possible warning signs of FDIA in children include the following: The child has a history of many hospitalizations, often with a strange set of symptoms. Worsening of the child's symptoms generally is reported by the mother and is not witnessed by the hospital staff. The child's reported condition and symptoms do not agree with the results of diagnostic tests. There might be more than one unusual illness or death of children in the family. The child's condition improves in the hospital, but symptoms recur when the child returns home. Blood in lab samples might not match the blood of the child. There might be signs of chemicals in the child's blood, stool, or urine.  Failed To Load Title |
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Posted: 3/4/2019 9:45:57 AM EDT
[#50]
Quote HistoryQuoted:
Reading stuff like this is a reminder of why I'm hesitant to disclose my PD and bipolar type II diagnosis on intake paperwork. Quote HistoryQuoted:
Quoted: I bet she’s well known to the local ER and I bet she could give us a earful about how docs neglect and don’t believe her. Yes? Do you think we choose to have crippling personality disorders? do you think I enjoy having the emotional stability of a fucking toddler at times? I wouldn't wish living with BPD on my worst enemy. There's a reason so many of us commit suicide. |
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