I only learned today that gastroparesis is actually very uncommon, although i always thought its one of the most important complications that you will ever acquire as a complication of diabetes mellitus.
So i called the Registra regarding the problem:
A 73yo gentleman with a background of type 2 diabetes diagnosed 6 years ago accidentally who has also developed a lot of other complications big or small you name it-
Pre- proliferative retinopathy
Sensory Neuropathy- so many bloody ulcers
Autonomic neuropathy- gets so many hypers and hypos, pancreas is crap
Nephropathy- protein in urine ++++
Htn
Hyperlipidaemia
And he's had 8 weeks history of vomitting and non bloody watery diarrhoea which happend 3 times every week regardless of time. Hence NOT nocturnal diarrhoea. Not ureamia related. NOT hypothyroid. Infection??? probably too well for that. Gastroparesis is the only thing that came up to my mind but as soon as he listened to my history he said: it's is very rare and it's NOT GASTROPARESIS.
i'was shocked for a mo and he added "first of all it would be type 1 diabetes. 2ndly hba1c should be more that 7, thirdly they would have diabetes more than 10 years, fourthly they would have postprandial vomitting and on and on and on he rap off the endocrine stuff which i dont' really understand.
I hope he did has gastroparesis, at least now i know i can prescribe metoclopramide to him and he'll disappear and live for symptom free for the next 20 years. Just too tired for endocrine. Draining my cells away, similar to hemolysis, bit by bit, i think my brain has shrunken by the meaningless, non intelligent thigns that i do on a daily basis.
SHIT, and this is only the third week. When would i get out of the internship system?
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