Consecutive Health Challenges: Seeking Guidance
Hello everyone, I’m a 22-year-old male in good physical shape. Over the last couple of months, I've encountered a series of perplexing and bothersome symptoms, and I would appreciate any insights you might offer. Notably, before this period, I rarely faced serious health issues and generally maintain a nutritious diet. Here’s a summary of what I’ve experienced so far: - Approximately six weeks ago, I was stricken with Bell’s palsy, which has largely improved since then. - Shortly afterward, I was diagnosed with costochondritis, which is inflammation of the chest wall. - In the weeks that followed, I began to experience a lasting fatigue that has persisted without relief. - For over two weeks now, I’ve been plagued by several canker sores in my mouth that show no signs of healing, alongside a sore throat that intermittently appears. - Additionally, I've sustained two minor muscle strains in the past month, which is out of the ordinary for someone like me who was previously quite active. - Over the last three weeks, I’ve also noticed an alarming increase in hair loss — not in clumps but significant shedding, particularly noticeable during showers and on my pillow. - Although I haven’t had a fever or felt any swollen lymph nodes, I just have this overall feeling of being unwell, as if my body can’t bounce back from these issues as it normally would. I underwent a comprehensive blood test and urinalysis this past Saturday and am currently awaiting some of the results, but I do have some preliminary findings: - Urinalysis: all results came back negative (tests for chlamydia, gonorrhea, etc.). - Thyroid function appears to be normal. - However, my C-reactive protein (CRP) level was elevated at 19 mg/L, which I understand is considerably higher than the healthy range (should be <8). Is there anyone who might be able to shed light on my situation? The ongoing canker sores and hair shedding, coupled with my recent health complaints, have raised some concerns for me.
Answers (1)
7/15/2025, 4:30:59 AM
OpenHealth AI
It sounds like you've been through a challenging time with multiple health issues impacting your well-being. Your recent symptoms, such as canker sores, hair loss, and fatigue, combined with the elevated CRP levels, suggest that there may be an underlying inflammatory or autoimmune process at work. Let's break down your situation and outline some actionable steps:
Main Points:
- Persistent Symptoms & Elevated CRP: Your symptoms and the high CRP level suggest inflammation in your body.
- Need for Symptom Tracking: Keeping a detailed log of your symptoms may help identify patterns or triggers.
- Consider Lifestyle Factors: Assessing and optimizing lifestyle factors may contribute to your overall recovery.
Explanation:
- Canker Sores & Fatigue: Canker sores can be indicative of stress, nutritional deficiencies (like B vitamins), or immune system issues. Fatigue can arise for many reasons, including inflammation, stress, or inadequate rest.
- Hair Loss: Significant shedding can result from stress, hormonal changes, or nutritional deficiencies.
- Elevated CRP Level: This marker indicates inflammation. It's important to monitor and understand potential underlying causes, which could include autoimmune conditions, infections, or other inflammatory issues.
Next Steps:
-
Nutritional Focus: Ensure you're receiving adequate nutrients:
- Consider a balanced diet rich in vitamins (especially B vitamins), zinc, and iron.
- Stay hydrated.
- If you suspect a deficiency, consider discussing supplements like vitamin B complexes or zinc.
-
Monitor Symptoms: Keep a daily journal to track:
- Canker sore appearance and duration.
- Any new symptoms or changes in fatigue levels.
- Patterns in hair shedding (timing, severity).
-
Stress Management: Incorporate relaxation techniques:
- Consider practices like deep breathing, yoga, or meditation.
- Engage in light physical activity if you're able; it can help alleviate stress and improve mood.
-
Follow-Up on Test Results: Ensure you discuss the following with your healthcare provider:
- The significance of the elevated CRP level.
- Further evaluation for conditions such as autoimmune disorders (like lupus or rheumatoid arthritis) based on your symptoms.
-
Lifestyle Adjustments: Ensure you’re getting enough sleep and managing stress levels effectively, as these can impact recovery.
If your symptoms worsen, or if you notice new concerning signs (like fever or more severe fatigue), consider reaching out for further evaluation sooner rather than later. You're not alone in this, and with careful monitoring and appropriate adjustments, there's a good chance that you'll start to feel better again. Let me know if you have any questions or need further guidance!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - 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**Portocaval shunt: 9.9 mm** (no change, continues to drain directly into the inferior vena cava avoiding liver acinus) - **Arteriovenous shunt: 4.4 mm** (no alteration) - **Three nodular cystic lesions** in perivascular space, maximum size 11.6×20.7 mm, enhancing in the venous phase - **Portal vein: 6.1 mm** (noted during porto-venous phase) - Arteries show no filling abnormalities - Intrahepatic bile ducts remain non-dilated - Gallbladder is elongated and slightly bigger, free from stones - Pancreas: normal - Spleen: measures 66.9×38.5 mm (not enlarged), splenic vein is 3.6 mm - Kidneys: normal placements and structure - No excess fluid detected in the abdominal cavity - No visible changes in lymph nodes **MSCT ANALYSIS:** "Congenital portosystemic shunt indicative of Abernethy malformation, unlikely to be AVM, presence of focal liver lesions cannot be ruled out." **RECOMMENDATION:** Engage with an abdominal and vascular surgeon. --- ## RECENT BLOOD WORK (December 2025 - January 2026) ### Complete Blood Count (January 19, 2026): - WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 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Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? 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