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Doctor Q&A for Dr. Kevin Carr

A 33-year-old male asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
Specific location?: Specific location matters a great deal. If the pain is at the bottom of the heel and hurts most with the initial steps of the morning, I would think plantar fasciitis. Heel spur would also be a consideration. Any lateral pain would make me think of a soft tissue injury (ligament or tendon). A physical exam and perhaps imaging may be in order.
A 33-year-old male asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
Context needed...: This would not be normal in someone who is not engaged in new vigorous exercise/training. Joint pain (versus muscle pain) would make me think of overuse conditions such as osteoarthritis or autoimmune disorders (where the body erroneously attacks the joint lining.) A good collection of history of presentation coupled with a focused exam may shed light on what the underlying problem is.
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A 23-year-old female asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
This could be...: This could be androgen (eg. testosterone) excess due to environment or genetic factors. Risk factors include obesity or family history. Polycystic Ovarian Syndrome comes to mind--the diagnosis is based on two of the following three findings: lack of regular menstrual bleeding, high androgen levels, and the presence of ovarian cysts--which may be detectable by ultrasound.
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A 21-year-old female asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
There is a reason.: I agree with Dr. Ferguson. Nausea is incongruous with the ability to thrive--it limits caloric intake and impacts quality of life. Causes of chronic nausea can include GERD, liver disease, food allergy, marijuana usage, medication side effect, stomach ulcers, slow stomach emptying, or migraines to name a few examples. Labs and endoscopy may be needed to drill down your specific cause.
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A 22-year-old male asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
Consider evaluation.: With reported symptoms of generalized itchy skin (pruritus) after bath or shower, I would be concerned with ruling out polycythemia vera--an abnormal condition in which your bone marrow makes too many red blood cells. Itching is a classic symptom after getting out of a warm bath or shower. A simple blood test would reveal this. Also consider check of liver health, bile salts on skin cause itch.
A 52-year-old male asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
Kidney health:: 1 of the most important factors for maintaining kidney health is maintaining adequate hydration. chronically poor hydration resulted in reproduction of urine with higher concentration of waste products that can be injurious to the kidneys. As a rough guideline, men and women should consume approximately 1 L (1000 mL once) of water daily to help the kidneys function at their best.
A 19-year-old male asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
Yes...: Stress interferes with the release of hormones from a part of your brain (hypothalamus) causing a decrease in hormones that tell your ovaries to make estrogen and to ovulate--thus affecting when your uterus bleeds. Stress can cause late periods, no periods, or irregular periods. How you cope with stress and learn to relax plays a role in this process as well.
A 21-year-old male asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
Nothing post-puberty: There are supplements that can increase testosterone levels and DHT (Creatine, Forskolin). The penis normally begins growth at ages 9 -13 and completes growth by 19 to 22 yrs. Given your age, unless you have androgen deficiency, it is less likely that DHT will cause more growth of the penis. I can find no credible study that normal adults benefit from DHT for penis length. But my search was brief.
A 20-year-old female asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
Creatine/creatinine: CK-MB (creatine kinase) is an enzyme that builds. Creatinine is a breakdown product of CREATINE. CK-MB adds phosphorus group to CREATINE (made by liver to provide energy) to make CREATINE PHOSPHATE (energy reserve molecule) which gets broken down at a constant rate to form CREATININE--a marker for kidney function. Meanwhile, CK-MB is marker for cardiac damage.
A 25-year-old male asked:
Dr. Kevin Carr
Internal Medicine 20 years experience
In 400 characters...: Sinus rhythm=normal electrical discharge of cardiac muscle from sinus node in right atrium. Repolarization=cells return to rest after electrical discharge. Early Repolarization=some regions going to resting phase earlier than others. May be harmless in young people or athletes—it appears as upward sloping elevations of the ECG more to the front of the heart. Controversial whether this is harmless.
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