Dr. Margaret Aranda, M.D.

Headaches can be from simple stress that cause neck or scalp muscles to knot up. Or a headache can be from something more complicated like a brain tumor, which can be very rare indeed. Either way, you can either book a non-urgent, elective appointment for evaluation with your primary care doctor, or wait until you are in the middle of the next headache and head to the emergency room. The doctor should spend a lot of time asking you multiple questions about headaches. Here are just a few questions:

How long you have had them?
How high does your pain go up?
Is the pain sharp or dull, constant or occasional?
Does anything trigger them?
What is associated with them?
Do you get nauseated or throw up?
Any vision changes?

The physical exam is very important, as the doctor may find it necessary to order a CT or MRI. Unless you have fevers or a stiff neck, no one should want to put a needle in your back to inspect the fluid around your brain and spinal cord for infection. If the scan is perfectly normal, you can stop worrying about a brain tumor, which is a big relief! If the scan shows a tumor or a lesion causing extra fluid on the brain, you should be evaluated by a neurosurgeon. Continued headaches deserve an evaluation by a neurologist who specializes in headaches. You can find a local and good one through your PCP, and/or check for a local doctor with high ratings on Yelp.

Food allergy testing is usually composed of minute food ingredients that are injected under the skin. If you are allergic, your body’s immune system will defend your body by causing a localized rash. Usually, a big variety of ingredients are separately injected into a pattern on the back. One can bypass the need for this test by first going on an Elimination Diet. It eliminates everything most people are allergic to, like eggs and dairy. For this reason, I regularly recommend the Whole 30 Diet for allergies; you do it for just 30 days. At the end of the 30 days of whole food, you add back one food at a time. If you subsequently get bloated, nauseated or have a rash, guess what? You’re allergic. Millions have done the Whole 30 Diet, they have books and a Facebook group too. It is a 12-step program you should research before going on it. Set your start date, do not break the diet, and be well in the way to avoid triggering allergies and inflammation with food!

All the best!

Acupuncture is not first-line therapy for rashes. In fact, it is most proper to first determine what is causing the rash, so you prevent them. Look at diet, detergents, and environmental influences.

When your urine is clear, it means your body has enough water. When your urine is dark, it means your body is low on water, and is holding on to it. When your urine is as clear as water and there is a lot of it, you probably have heart failure and are taking a diuretic that removes water from the body.

The pituitary gland in the brain triggers the kidneys to hold on to or not hold on to water. After a traumatic brain injury, the pituitary gland may fail to hold on to water; this can lead to dehydration and a low platelet count, along with complaints of both thirst and frequent urination. This condition is called diabetes insipidus, a life-threatening condition that can lead to dark urine and dehydration, a low platelet count, bleeding, kidney failure and death.

So it is good to pay attention to the color of your urine, especially after head trauma.

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Anyone with headaches and dizziness would have anxiety. In your case, the history or story of what happens is super important to figure out the cause. Only after getting the right diagnosis can you hope to get proper treatment.

I had to see about 20 doctors before a cardiologist figured out I had dysautonomia. And it is impossible to diagnose you without a physical exam. So, your best bet may be to keep seeing different doctors, until you get a diagnosis. Check with different neurologists, cardiologists and headache specialists. Because allergies can also mimic different illnesses, go on the Whole 30 antiinflammatory diet for 30 days - check out www.whole30.com. Keep going to new doctors until you get a diagnosis.

Symptoms of pneumonia include things that make the lungs move in and out. This includes:

-General fatigue or malaise
-Fever
-Shortness of breath
-Chest pain
-Inability to take a deep breath
-Cough
-Cough with sputum or excretions

A helpful home device to have is a pulse oximeter, one that has a clip on the finger with a light that reads oxygenation. A normal oxygen saturation would be 96-100% and a pneumonia can read 92-96% or lower.

Dizziness after standing up is known as orthostatic hypotension. When this happens, check your blood pressure and heart rate. Your blood pressure medication dose may need to be decreased. You may also be dehydrated. Either way, the doctor who prescribed your blood pressure medication needs to be informed.
All the best!

Most people with only one kidney live a normal life span. If you were born with one kidney, it does the work of two from birth. If you donated or lost a kidney, the remaining kidney does not compensate and you will lose about half the function. In the latter case, if the remaining kidney function was lost, you would need dialysis or a transplantation. So, it is doubly important to protect the one kidney you have by living healthy. Steps to take to protect one kidney’s function include:

* Avoid high blood pressure
* Avoid diabetes
* Avoid injury or trauma by not playing football or contact sports
* Eat a healthy diet
* Exercise regularly
* Keep a normal weight
* Avoid dehydration
* Avoid medications like nonsteroidal anti-inflammatories (NSAIDS)

You should also see your doctor at least once a year, to check the blood for creatinine and the urine for protein. So go ahead and enjoy the healthiest possible lifestyle to the fullest!

Certain foods are acidic, trigger stomach acid, and are best avoided. So, half the remedy is to avoid triggering it; the other remedy is to eat foods that help.

Lower abdominal pain that you can press on and it reproduces the pain can be one of many different things. You describe pressing also triggers the start of what feels like a bowel movement. Would need to ask more questions, check for a fever, and do a physical exam to see if you have normal bowel sounds, pain on pressing, and exactly where that pain is located. Possible diagnoses include: muscle tear, constipation, hernia, bowel obstruction, and for females, something to do with the ovaries, like a cyst. In extreme pain with a fever, the appendix is always a possible culprit, as well. Head to an Urgent Care for specific evaluation.

Dear Difficulty Walking,

Patients with diabetes get painful and sometimes weak legs. That being said, additional problems occur with leg weakness that leaves you unable to lift them or adequately walk with them. First of all, you should not be operating a bus if your braking or acceleration response times are slowed by even one fraction of a second. If you cannot immediately and quickly brake with hard pressure, you jeopardize everyone on the bus. There is no way to cure this problem without knowing more and examining you, but the biggest fear is a spinal cord or muscle weakness problem that needs a diagnosis. Things like multiple sclerosis, muscular dystrophy and spinal adhesive arachnoiditis may be considerations. My best advice is to go to a county free clinic, as your diabetes may also be out of control and your diabetic neuropathy needs a baseline evaluation by a diabetic expert or a neurologist, then further testing by physical exam. You may need an X-ray, MRI, and nerve conduction study. Fight for your diagnosis.
All the best!

There has been a move from mercury to digital to infrared thermometers. While infrared thermometers offer the ability to skip touching any part of the patient’s body, they can generally read when held 1-2 inches or about 2-4 cm from the forehead.

Regarding “zoning out” a lot and seeing the ground move, I’d have to ask more questions. If it happens when you stand up, maybe it’s a “head rush” because you stood up too fast. You need to sit down and put your head down to reestablish more brain blood flow. If it happens when you’re hungry, it may be a low blood sugar and you need to drink orange juice. If your brain has a tendency to have seizures, it may be a “prodrome” warning sign and additional information may see if an EEG is necessary. It is okay to see a doctor by telemedicine who can help determine what is happening.

If you have shortness of breath and a sore throat, especially with a fever, it is best to consider it could be coronavirus. Depending on where you live and how sick you are, self-quarantine for 14 days (New York City), or see a teledoctor, visit an Urgent Care or Emergency Room. It all depends on where you live and how sick you are. If you have difficulty breathing or blue lips or anything concerning, call 911.

The best things for a patient who is a diabetic with high blood pressure to eat: Vegetables. Raw vegetables. A low glycemic diet. High protein with fish and chicken, little beef. Start with the anti-inflammatory Whole30 Diet, as hundreds of thousands have successfully done. Join their Facebook group, read books and articles. Just takes 30 days to eliminate everything you could be allergic to, then on Day 31, add back one new food at a time. If you get bloating or diarrhea, you’re allergic. Pick a starting date, then do it!
All the best!

Yes, one can catch pneumonia from someone else who has it. The usual way is through sharing body fluids, like coughing into the air then rebreathing it.

Best to stay away from the person, and have them avoid coughing on or toward you. You can stay six feet away and wear a face mask and gloves. Wash hands often (sing Happy Birthday twice), and avoid touching the face.

Many healthy spouses have lived with an otherwise healthy partner without also catching pneumonia. If your immune system is compromised, consider high-potency vitamin C and immune defense supplements.

Also, of course watch that the primary infection could be coronavirus, with pneumonia as the secondary infection and if you have doubts, be seen by your primary care doctor on telemedicine.

Stay well, stay indoors.

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Yes, a cold can definitely turn into a bronchitis. “-itis” means “inflamed” as in "tonsillitis" and “bronchitis.” When the common cold goes from the nose to the deeper breathing tubules that make up the lung airways, the bronchioles become inflamed and can make extra mucous that can carry bacteria out of the lung tissue. Inflammation of the mucous-filled lung segments can irritate the airway, causing a severe cough or leading to a pneumonia. Susceptible patients with reactive airways can have an asthma attack. When in doubt, you need to be seen in person to evaluate the need for everything from an antibiotic to airway support.

In general, donating a kidney at age 19 will not shorten your life. But as with any anesthetic and surgery, a kidney donor can end up with complications or even death during or after surgery - but this is extremely rare. Ask to talk to the anesthesiologist who will do your case, and they’ll provide you with both general and individual risks. You can change your mind any time before receiving a sedative on the way to the operating room. It will be a more painful procedure for you than for the patient getting your kidney. And you would need a good doctor for postoperative pain management. Ask who is going to be writing prescriptions for your postoperative pain. And make sure your pharmacist will fill it. Donating a kidney is an exceptional thing to do for someone else. Once you pass the immediate postoperative period without complications, your life is expected to be just as long as usual. In fact, you will naturally be more careful at taking better care of the one kidney you have.

You didn't mention the diagnosis. What is the diagnosis? If he has no diagnosis, perhaps he needs another study or a consultation with a neurologist. He may also need a spiral CT. I got over a vertebral artery dissection and while I still have problems, I was vestibular for about twelve years.

Yes, depending on the diagnosis, vestibular exercises can work. It is a challenging situation because at first, and for quite a while, the exercises may make your son nauseated. He may even vomit. That is because the nerves have to learn new roads to travel. Without pushing too hard, he has to stop when he feels sick; with time, can then do it longer. Keep track to watch the progress because it's rewarding to see him doing more and more.

The more he works out this part of his brain, the thicker and more 'talkative' the nerve tracks become, and the better he will get. So keep it up and challenge him by letting him pick out some oranges or apples at the grocery store, and one day at a local farmer's market. It gets his eyes moving back and forth in real life, for something that he may really want (instead of a bland exercise in an office building). His motivation leads the way, so keep up the encouragement!

In this regard, keep looking for fun ways of encouragement for practical use, but learn to stop before getting too sick.

A serious vertigo attack can feel like a "gray out" or "seeing spots" with lightheadedness, near-fainting, or fainting. Laying down gets more blood to your head, so you feel better.

When some people stand up, they get dizzy right away. They could just be dehydrated and need to drink some water, or they could have a medical condition like dysautonomia or postural orthostatic tachycardia syndrome (POTS). Dysautonomia is dysfunction of the autonomic nervous system, which regulates all your automatic body functions like food digestion, heart rate, and breathing. When this system goes awry, your body can't get enough blood to your brain when you stand up.

If you feel like fainting every time you stand up, a cardiologist can test you in the Tilt Table Test, where you're strapped to a flat table. They press a button then lift you up. If you faint, you have dysautonomia. We test for this in the office by taking your blood pressure during three times: laying down for 5 min, the standing up, then one minute later (still standing up). If the heart rate exceeds

The treatment starts with hydration and salt, so drinking lots of water is a bigger rule than normal. Wearing compression stockings is a big help, as well as wearing an abdominal binder, support hose and tights. There are medications like metoprolol to slow the heart rate, and midodrine to increase the blood pressure.

Other causes of dizziness have to do with the inner ear, brain tumors and maybe even the heart. Seeing a cardiologist is in order, to be sure it's not your heart and to see if you need testing. Best to you!