OpenHealth Q&A

Get answered by medical professionals

Seeking Guidance on Managing Hypermobility During Consultation Wait

8/10/2025, 9:30:42 PMMale25-34

I’m a 22-year-old assigned female at birth (AFAB) and currently navigating a number of health challenges, including Type 1 Diabetes, chronic pain and fatigue, scoliosis, and asthma. I also deal with gender dysphoria, autism, ADHD, and complex PTSD. My management plan includes the use of a closed-loop insulin pump, a daily regimen of 100mg lamotrigine, as well as weekly IM testosterone injections (0.8mg), along with gabapentin, Benadryl, and over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, and Tylenol as needed for pain relief. While my medical team suspects that I have additional conditions, I’ve been referred for an evaluation for Ehlers-Danlos syndrome, with the appointment scheduled for October. This specific concern is the primary reason I’m reaching out today. I began physical therapy in April due to persistent back pain, which led to the discovery that I have hypermobility. After some initial assessments, I received my referral for the upcoming evaluation. Although physical therapy has been beneficial to some extent, I face challenges due to limited session availability compounded by insurance constraints. My therapist has advised that I decrease the frequency of using my joint braces and stabilizers for my knees to enhance my muscle engagement. There are times this approach works, but I also find myself re-injuring my knees, causing me to revert to using stabilizers, especially at my job where the risk is higher. Recently, my right knee has become increasingly troublesome, with issues in maintaining alignment and frequent dislocations due to minor movements. I’m hesitant to over-rely on my braces, fearing a setback in my therapy progress, yet I'm at a loss for alternative solutions while fulfilling work obligations and daily errands. I've utilized a significant portion of my physical therapy sessions for the year, and my therapist is fully booked for the foreseeable future. This fall, I’ll be returning to school to pursue a career that accommodates my health needs, as physical labor in particular has proven challenging for long-term employment. Are there specific supplements, techniques, or tools I could incorporate to assist with managing my hypermobility alongside my physical therapy exercises? Additionally, what questions might be beneficial to pose to my healthcare team? I would greatly appreciate any guidance or advice on this matter.

BloatingGastroenterologyInternal Medicine

Answers (1)

Cony

8/10/2025, 9:31:05 PM

OpenHealth AI

It sounds like you're dealing with a complex array of health challenges, and managing hypermobility in the context of your existing conditions can indeed be difficult. Let’s focus on practical steps you can take to better manage hypermobility while preparing for your upcoming evaluation.

Main Points

You want strategies to manage hypermobility, especially around your knees, while working and continuing physical therapy. It's also important to consider how you can engage your healthcare team effectively.

Explanation

Hypermobility can lead to joint instability and increased risk of injury, so it’s understandable to feel concerned about maintaining balance between support and progress in therapy. Your body needs strength and stability but must also avoid dependency on braces. Here are some strategies that may help:

Specific, Prioritized Next Steps

  1. Strengthening Exercises: Work on controlled strengthening exercises that target the muscles around your knees. Focus on low-impact activities like cycling, swimming, or specific resistance exercises that your therapist can recommend. This will help build stability without over-relying on braces.

  2. Modification of Activities: When engaging in activities that may overstrain your knees, use modifications or alternative methods to perform tasks while minimizing knee stress. For instance, consider using ergonomic aids at your workplace or during daily errands to reduce strain.

  3. Pain Management Techniques: Continue utilizing NSAIDs as needed, but also consider incorporating gentle physical modalities such as heat or cold therapy to manage pain after any re-injury or discomfort.

  4. Incorporate Supportive Tools: Since you’re hesitant about using braces, consider using compression sleeves or kinesiology tape. These can provide some support and proprioceptive feedback without being as restrictive as traditional braces.

  5. Dietary Supplements: Talk to your healthcare team about supplements that may support joint health, such as glucosamine and chondroitin, although evidence is mixed. Omega-3 fatty acids, either from diet or supplements, can help reduce inflammation. Always consult your healthcare provider before starting any new supplements to avoid interactions with your current medications.

Questions for Your Healthcare Team

  • What specific strengthening exercises can I do at home to support my knees without putting them at risk?
  • Are there any additional monitoring strategies to assess my joint stability during physical therapy?
  • Can you recommend resources or additional therapies that might be beneficial, such as occupational therapy or a different approach to pain management?
  • What lifestyle modifications or supports would you suggest based on my work and daily activities?

Final Note

It’s great that you’re proactive in seeking solutions amid your challenges. Each step you take, even small ones, can provide relief and improve your function. Keep tracking how your body responds to these strategies as you discuss them with your healthcare team. If you have more questions or need support, don’t hesitate to ask.

Related Questions

Seeking Relief from Mild Fecal Impaction: Should I Go to the ER?

At 20 years old, I find myself dealing with a frustrating issue: fecal impaction. It's not something I've faced before, or at least I can’t recall, but I’ve had chronic stomach difficulties throughout my childhood, including constipation from ages four to twelve. Recently, I've been experiencing more digestive challenges after a few years of feeling normal. Currently, I’m under the care of a gastroenterologist, and we’re working on diagnosing the underlying problems. For about five days now, I haven't been able to relieve myself. While I’ve had considerable gas, that’s been the only symptom. Today has been particularly difficult; I’ve spent the last 11 hours in the bathroom grappling with severe discomfort and impaction. Each attempt to relieve the situation is excruciating, to the point where my body is resisting the effort—it’s so painful that I find myself in tears. I imagine this is what birth must feel like. I suspect this intense fear and pain are remnants of my past struggles, as for many years I’ve feared using the bathroom due to the agony it causes. Despite trying various remedies like Miralax mixed with coffee, a bullet suppository, and even a manual approach with gloves, nothing is yielding results. I’m genuinely tempted to head to the emergency room and ask them to put me under so they can help me without the pain. My mother suggests they would likely opt for a liquid suppository treatment like they did during my childhood, which was quite traumatic. I’m torn—it feels like the ER might be my last resort, but I'm concerned they won’t take me seriously since my situation doesn’t seem dire. How foolish would it be to bring up wanting sedation? I desperately want to avoid this pain; it’s becoming increasingly difficult, and I’m fighting back tears from the frustration. Can they truly provide sedation for this type of issue even when it isn’t severe? I worry that my parents might react negatively to my quest for relief and think I’m being dramatic. I’m utterly drained and don’t know where to turn. When there’s no painful push against my body, I can’t even sense the severity of the issue, yet, I am experiencing leakage, leaving me unsure. Would it be unreasonable to pose this question to the doctors in the ER? I apologize if this message is jumbled; I’m also dealing with a migraine, making it hard to focus. For context, my daily medications include phentermine, iron supplements, and vitamin D. I stand at 5’4” and currently weigh 204 pounds as part of my ongoing weight loss journey.

Stomach PainGastroenterologyConstipation
Male25-34
7 hours ago

Interpreting My Gastrointestinal Discomfort

A 26-year-old female, weighing 155 pounds, has a background of experiencing gastroesophageal reflux disease (GERD) and anxiety. She has been using marijuana for several years and is currently taking venlafaxine at a dosage of 150 mg each day. Residing in the Midwest USA, she identifies as white. On January 20th, she experienced what she initially believed to be a low blood sugar episode. Due to being preoccupied and busy, she had not consumed much food throughout the day. Consequently, she felt lightheaded, nauseated, pale, and was sweating. To alleviate these symptoms, she consumed around 60 to 80 grams of carbohydrates once they began, but it took roughly 2.5 hours for her to start feeling better. The following day, she faced additional discomforts including nausea, heartburn, body aches, trembling with chills and sweats, along with diarrhea. These symptoms persisted for a few days. By January 23rd, she consulted urgent care, where the medical team suspected a stomach virus and advised her to let it run its course. Regrettably, her stomach has not returned to its normal state since that incident. She has been experiencing occasional heartburn and indigestion reminiscent of her previous severe GERD episodes. Additionally, she is suffering from lower abdominal cramps, particularly triggered by consuming items like popcorn or spicy foods, which feels akin to irritable bowel syndrome (IBS) symptoms. During the height of her symptoms on January 20th, she ceased smoking. She partook in smoking a few times between January 24th and 28th, without noticing any changes in her symptoms – positive or negative – and has refrained from smoking since then. It is worth noting that she has not experienced any vomiting or severe abdominal pain typically associated with cannabinoid hyperemesis syndrome (CHS). Are her symptoms indicative of CHS? She intends to abstain from smoking yet seeks clarity on the underlying cause of her discomfort. She has read about post-viral IBS and is curious if the suspected stomach virus has reignited her GERD, which had been stable for several years.

BloatingIndigestionAcid Reflux
Male25-34
14 hours ago

Exploring Probiotic Effects and Antibiotic Strategies in Gut Health

Greetings, M30. Is it possible that consuming an excess of probiotics could lead to SIBO or a similar condition? Earlier this summer, I suffered from a campylobacter infection, and in an attempt to remedy that without realizing its full extent, I resorted to high doses of probiotics. This approach, however, only aggravated my situation. I experienced severe bloating, intensified brain fog—especially after consuming carbohydrates—and following a comprehensive examination of possible causes, including an initially misleading negative test for c. jejuni that later revealed IgG antibodies in my blood, I was prescribed rifaximin (200mg four times a day). Unfortunately, after five days of rifaximin treatment, my symptoms escalated dramatically, resulting in excruciating lower abdominal pain and a marked intolerance to carbohydrates. Through my research, I discovered that the probiotic strains I had been using were sensitive to antibiotics, so I requested that my physician switch my medication to amoxicillin, which promptly resolved the issues I was facing. Complicating matters, I later learned that I had been contending with an acute bartonella infection, which likely contributed to my motility problems. As the year progressed, I indulged in kimchi after having been on antibiotics for bartonella treatment for about a month. However, I had to stop the antibiotics over the Christmas holidays when I developed rashes from herpes on my face and required alternative treatment. Following my kimchi overindulgence, I began to experience bloating again, cognitive fog intensified, and I felt a toxin-like sensation after consuming larger amounts of carbohydrates, alongside a newfound intolerance to wheat products. My doctor once again prescribed rifaximin as the primary treatment, but I am starting to notice that familiar acidic sensation in my abdomen returning. Is this reaction indicative of die-off symptoms, or could it mean that rifaximin is targeting competitors of the kimchi bacteria in my gut, resulting in their proliferation and creating a cycle where lactic acid bacteria alter the colon's pH, promoting further growth of lactic acid producers? I suspect this situation mirrors what transpired during the summer months. Would switching back to amoxicillin be advisable, or might I need to consider amoxiclav instead, given that the kimchi contained fish sauce which might be a source of beta-lactamase? Best wishes,

BloatingStomach PainIndigestion
Male25-34
15 hours ago

Eight Years of Persistent ‘Hunger’—Is It a Functional Gut Disorder?

Greetings everyone, I’m a 28-year-old woman standing at 5 feet 4 inches, and for nearly eight years, I have struggled with a constant, hollow sensation in my upper abdomen that resembles hunger. Here are some key points about my experience: - This sensation arises between meals or soon after I have eaten. - It gets momentarily better after eating but eventually returns. - Though it feels like hunger, I know it's not genuine hunger. - Mornings are especially tough as the sensation intensifies. I maintain a regular meal schedule and consume enough calories without any restrictions. Currently, I find it difficult to trust my hunger cues, so I'm tracking my calorie intake. I do not take any medications and have previously used proton pump inhibitors without any noticeable improvement. Additionally, I neither smoke nor consume alcohol. Visits to my general practitioner have yielded no definitive diagnosis, with much of the feedback being centered on dietary adjustments. I am currently facing a waiting period of approximately eight months for a gastroscopy. Strangely, I also notice that I feel particularly weak during my workouts, despite my calorie intake being sufficient. Has anyone else faced a similar long-term issue? Did you find it to be functional dyspepsia, gastritis, visceral hypersensitivity, or something entirely different? Were you able to obtain assistance through a gastroenterologist, a dietitian, or therapy? Thanks for your insights!

IndigestionGastroenterologyNutrition
Male25-34
15 hours ago

Rapid Heart Rate During Illness

A 27-year-old male, standing at 6 feet 3 inches tall and weighing 275 pounds, presents as non-smoking with a medical regimen including buspirone, sertraline, and Nexium. He does not consume alcohol or use illicit drugs. His medical background highlights anxiety and a previously noted Wolff-Parkinson-White (WPW) pattern observed on an ECG in 2023, without any prior ablation or recorded arrhythmias. On February 5th, I visited the emergency room after experiencing a sudden and alarming increase in my resting heart rate to approximately 130 beats per minute while at home. This spike was particularly distressing given my history of chronic anxiety. Reflecting on the earlier part of the day, I recall experiencing mild body aches, a cough, and a sensation akin to a low-grade fever, which now appear to have been early signs indicating I was becoming ill. Once at the emergency room, the medical team administered 10 mg of propranolol, resulting in a gradual decrease in my heart rate from 130 to the mid to upper 90s over a span of about one hour and 45 minutes. The ECG revealed only sinus tachycardia, and notably, the doctor informed me that the WPW pattern from 2023 was no longer evident. All laboratory tests returned normal results with standard electrolyte levels, kidney function (eGFR at 108), and a complete blood count showing only a typical stress response characterized by elevated neutrophils and reduced lymphocytes, alongside normal urine tests. There were no indications of dehydration, infection, thyroid irregularities, or arrhythmia. After returning home, it became clear that I was battling a viral infection. I experienced chills, extensive body aches, and fever peaking at 101.8°F, as well as a cough with medium brown mucus (not excessively dark or bright red). I have not experienced shortness of breath or wheezing at rest. Notably, my heart rate has paralleled my fever. When my fever ranges between 101°F and 102°F, my resting heart rate typically aligns between 105 and 125 beats per minute. Conversely, as my fever declines into the 99°F range, my heart rate drops to the 80s and 90s. Under normal circumstances, my resting heart rate hovers around 60 beats per minute. Currently, I am measuring a temperature of approximately 100.6°F to 100.8°F, with a heart rate around 110 to 115 beats per minute. About an hour ago, I took Tylenol, and am staying hydrated and resting. The only discomfort I feel is due to persistent coughing. I have a few inquiries: - Is this heart rate fluctuation typical during a viral infection accompanied by fever? - Should I expect to see an elevated heart rate persist even during sleep when my fever is elevated? - Is there any cause for concern regarding my previous WPW even though the recent ECG indicates that pattern is no longer present? Thank you for your assistance.

HeartburnIndigestionInternal Medicine
Male25-34
20 hours ago