Dr. Hratch Karamanoukian

Phlebology 32 years experience

Mondor's disease: This is consistent with superficial vein thrombophlebitis of the breast, also known as Mondor's disesse. Topical heat, ibuprofen and see your primary ... Read More

1.5k viewsAnswered >2 years ago

2 thanks

A 19-year-old male asked:

2 days ago i noticed a lump on anus it's pain to touch and during defecation and today i feel nauseous i'm too scared and shy to see my doctor?

Phlebology 32 years experience

Hemmorrhoid: This could be a thrombosed hemorrhoid or anal stricture. Nothing to be ashamed of as it is a common problem. See your doctor.

1.4k viewsAnswered >2 years ago

A 37-year-old female asked:

Can i exercise bike 2 days after evlt?

Phlebology 32 years experience

EVLT: You can exercises within minutes after EVLT. I actually recommend my patients to do that immediately after they drive home following EVLT. This is ver... Read More

1.5k viewsAnswered >2 years ago

A 39-year-old female asked:

Doc said, inflammation in back right lung where it hurt, was coughing bad, still coughing a bit, but now severe nausea, and vomiting, with lung pain??

Phlebology 32 years experience

Chest pain: There is no such thing as 'lung pain'. There is pleuritic pain related to inflammation of the inner lining of the chest due to problems in the thoraci... Read More

1.4k viewsReviewed >2 years ago

Dr. Ed Friedlander and 2 doctors agree3 doctors agree

A 28-year-old female asked:

After i have a couple drinks i get pressure and pain in my ribcage. this happens even when i go days without drinking. any reason why?

Phlebology 32 years experience

GERD: Referred pain could be explanation because alcohol may be irritating your esophagus. It is an unusual presentation nevertheless. I have seen a lot of ... Read More

1.4k viewsReviewed >2 years ago

Dr. Jeffrey Juchau and 3 doctors agree4 doctors agree

A male asked:

Am having the same problem of bitterness while drinking water only . first i felt it's some kind of water problem but after changing waters and even t?

Phlebology 32 years experience

Water taste: I suggest that you start with a basic metabolic panel on your blood work to exclude simple electrolyte issues or kidney problems. If that is all norma... Read More

1.4k viewsAnswered >2 years ago

A 38-year-old member asked:

Hi docs, do you think i can get crutches for a bruised knee?

Phlebology 32 years experience

Yes: you should be able to get them at an urgent care after an exam.

1.4k viewsAnswered >2 years ago

A member asked:

I'm having a reaction to my allergy shots and my arms are really swollen. i took allegra at about 6:40 this morning, can i take benadryl (diphenhydramine)?

Phlebology 32 years experience

Allergic reaction: You should go to the ER now. You may need IV steroids.

1.4k viewsAnswered >2 years ago

A 30-year-old male asked:

Dull ache on left side of chest near arm pit and under left side of collarbone it bothers me when i lift with my left arm or pick up something heavy i?

Phlebology 32 years experience

Dull ache chest: This sounds of orthopedic nature and less likely to be cardiac given your young age (30) and the fact that it is positional in nature. Best to start w... Read More

1.4k viewsAnswered >2 years ago

3 thanks

A 29-year-old male asked:

What's most prevalent type of intestinal metaplasia? type 1, 2, or 3? how common is it for people to have im? what percentage develop further probs?

Phlebology 32 years experience

Intestinal metaplasi: Patients with the first phase of Barrett’s esophagus (intestinal metaplasia) have a combined risk of 1.4% per year of progressing to high-grade dyspla... Read More

1.4k viewsReviewed >2 years ago

Dr. Dimitri Novitzky agrees1 doctor agrees

A 50-year-old member asked:

Please recommend some tips on removing neck lines?

Phlebology 32 years experience

Neck lines: Transverse neck lines can be treated with strategic Botox injections and laser resurfacing. Often, volume fillers are also used to reduce these lines.... Read More

1.4k viewsAnswered >2 years ago

A 35-year-old member asked:

What causes palmar hyperhidrosis (sweaty palms)? is it contagious?

Phlebology 32 years experience

Hyperhidrosis hands: Palmoplantar hyperhidrosis is not contagious. It can be treated with topicals, sometimes oral anticholinergic agents, Botox injection, or micro ETS. S... Read More

1.5k viewsAnswered >2 years ago

5 thanks

A female asked:

Hi im a 13 year old girl and lately i've being having pain in my hands where my vains are, sometimes the vains bulge but not all the time, they are so?

Phlebology 32 years experience

Hand veins: Hand veins are normal in 99% of patients and pain is not likely to be pathologic. See your pediatrician for guidance.

1.5k viewsAnswered >2 years ago

A 27-year-old male asked:

Should i change from (aspirin&plavix) to apixaban to reduce embolus risk in 72yr hypertensive male with paroxysmal afib,scr1.7 cause i'm afraid ofbled?

Phlebology 32 years experience

Apixaban for A fib: Risk of bleeding is higher with Apixaban than with aspirin and plavix (clopidogrel) combination.

1.4k viewsAnswered >2 years ago

3 thanks

A 23-year-old male asked:

Prominent veins and visibly pulsing arteries in the palm of my hand and at my wrist and along the side of the hand from the thumb to the index finger.

Phlebology 32 years experience

Hand veins: Hand veins don't pulsate and hand veins are not prominent on the palmar side of the hand. These may be arterial if you are feeling pulses. You can sta... Read More

1.5k viewsAnswered >2 years ago

1 comment

12 thanks

A 19-year-old female asked:

I havent got a check up yet but i think i have heart palpitations. heart beats irregularly mostly when on period. what should i do in the mean while?

Phlebology 32 years experience

Palpitations: In a young person with a healthy heart, a good place to start the work up is an ECG followed by Holter monitoring and an echocardiogram. Hormonal alte... Read More

1.5k viewsAnswered >2 years ago

A 38-year-old male asked:

My right arm from my elbow to shoulder feels heavy and my deltoid just comes off my shoulder and abruptly stops not like my left side??

Phlebology 32 years experience

Shoulder dislocation: Your shoulder may be going in and out of the joint, dislocation. Best to see an orthopedic surgeon.

1.4k viewsAnswered >2 years ago

A 21-year-old female asked:

Suffering from exhaustion & fatigue due to my postural orthostatic tachycardia syndrome. sleep specialist can't help, iron tabs don't work. advice?

Phlebology 32 years experience

Postural orthostasis: A cardiologist needs to start managing you and in the interim, you should keep yourself well hydrated, perhaps take salt tablets and be careful when y... Read More

1.5k viewsReviewed >2 years ago

Dr. Susan Rhoads agrees1 doctor agrees

3 thanks

A 30-year-old female asked:

What is a "sharp costophrenic angles" on chest xray?

Phlebology 32 years experience

Costophrenic: This is a sign on chest xray implying there is no fluid in the recesses of the pleural cavity near the diaphragm at the level of the lateral ribs. Cos... Read More

1.4k viewsAnswered >2 years ago

9 thanks

A 17-year-old female asked:

Is it normal to have a rash/bad rash on my breasts? i breastfeed and i just had my first child a month ago. i was just wondering if it's normal.

Phlebology 32 years experience

Rash on breasts: This is not normal and you should be evaluated in the emergency room or by your primary care doctor. Proper treatment will allow you to continue breas... Read More

1.4k viewsAnswered >2 years ago

A 28-year-old male asked:

Testicle pain at night. occasional swelling in what feels like the tubes i guess. hard to pee and i have blood in my semen. been like this for months.

Phlebology 32 years experience

Testicular pain: What you are describing is not normal and you should seek an urgent evaluation by a urologist.

1.4k viewsReviewed >2 years ago

Dr. James Lin and another doctor agree2 doctors agree

A 34-year-old female asked:

Bad blood draw yesterday (venipuncture/8vials).immediately:red/blue, v.swollen&painful.now:flat,hard lump,bruise.do ruptured veins heal?just a leak?

Phlebology 32 years experience

Hematoma: The venipuncture for blood draw leaked and caused a hematoma outside of the vein or in the vein wall or both and this will heal in most cases without ... Read More

1.5k viewsAnswered >2 years ago

4 thanks

A 62-year-old female asked:

Can ultherapy, ultrasound facial lift cause swollen lymph glands?

Phlebology 32 years experience

Ultherapy: I have performed Ultherapy since 2010 and have never seen someone present after this procedure with lymphadenopathy.

1.5k viewsReviewed >2 years ago

Dr. Jan Lei Iwata and 2 doctors agree3 doctors agree

A 34-year-old female asked:

Varicose vein & saphenous vein valve grossly incompent. foot tingly/leg heavy now 6hr later top of thigh throbbing. in bed last 4hrs. worry?

Phlebology 32 years experience

Venous reflux: It would be prudent to seek a Duplex venous scan to rule out DVT. Most likely, this is related to the venous insufficiency. Once DVT is excluded, give... Read More

1.4k viewsAnswered >2 years ago

A 22-year-old female asked:

What causes phlebitis?

Phlebology 32 years experience

Phlebitis: Phlebitis is inflammation of a vein. itis means inflammation. Phleb means vein. Phlebitis can be from thrombosis (clot), also known as thrombophlebiti... Read More

1.4k viewsReviewed >2 years ago

Dr. Clarene Cress and 2 doctors agree3 doctors agree

A 27-year-old female asked:

I have a mild case of mvp and regurgitation. i'm getting a tingly face during and after exercising. should i be concerned?

Phlebology 32 years experience

MVP and MR: Mitral valve prolapse and regurgitation would not cause your facial tingling.

1.4k viewsAnswered >2 years ago

A 34-year-old female asked:

I seem to have hepatic hemangiomia, and its size is 1.1 inch. what do i need to care in my daily life? thank you in advance.

Phlebology 32 years experience

Hemangioma liver: If asymptomatic, hepatic angiomas can be observed at this size with serial ultrasound. Large symptomatic lesions can be treated with resection, RF abl... Read More

1.4k viewsReviewed >2 years ago

Dr. Susan Rhoads agrees1 doctor agrees

A 19-year-old male asked:

I am having occasional anal leakage. any advice?

Phlebology 32 years experience

Anorectal discharge: I recommend that you see a colorectal surgeon for an examination and possible scope.

1.4k viewsAnswered >2 years ago

A 29-year-old female asked:

What else can cause intermittent lymphedema, musc and joint pain, fatigue x 10 yrs. hiv neg, ana neg.

Phlebology 32 years experience

Lymphedema: The list of conditions that cause lymphedema is long. It is better to have intermittent lymphedema than chronic lymphedema. Given that you have had te... Read More

1.5k viewsAnswered >2 years ago

A 37-year-old member asked:

Is there a natural remedy to prevent deep vein thrombosis in the legs, such as herbs?

Phlebology 32 years experience

Natto: The Japanese eat a food (natto bean) that contains an enzyme, nattokinase, which lyses fibrin clots. Discuss with your doctor before you take this enz... Read More

1.4k viewsAnswered >2 years ago

A 34-year-old member asked:

Are women who have had breast cancer more likely to develop deep vein thrombosis?

Phlebology 32 years experience

DVT risk: Active cancer increases risk for DVT significantly. tamoxifen can increase risk for DVT and PE. See this link for guidance. http://www.ncbi.nlm.nih.go... Read More

1.4k viewsAnswered >2 years ago

A 37-year-old female asked:

I heard that there are tablets & creams for treating varicose veins. are they effective? do they have side effects ?

Phlebology 32 years experience

Citrus bioflavonoids: I have written 2 books about these supplements and they are available for free on my website: 1) Diosmin and Citrus Bioflavonoids for Venous Insuffici... Read More

1.4k viewsAnswered >2 years ago

A 35-year-old member asked:

What is phlebitis?

Phlebology 32 years experience

What is phlebitis?: itis means inflammation. Phleb means vein. Phlebitis is inflammation of a vein. Phlebitis can occur after placement of an IV catheter, or after blunt ... Read More

1.4k viewsReviewed >2 years ago

Dr. J. Lawrence Dohan and another doctor agree2 doctors agree

A 51-year-old female asked:

History of dvt in left leg with bilateral pes, now wear jobst stockings, since last feb, had hysterectomy in sept, lately, i'm having bil. groin pain?

Phlebology 32 years experience

Groin pain: It is important to get a Duplex vein scan but this rarely shows anything above the groin. In thin patients, the iliac veins may be visualized. Duplex ... Read More

1.5k viewsReviewed >2 years ago

Dr. Susan Rhoads agrees1 doctor agrees

A 42-year-old member asked:

Can a pacemaker expire?

Phlebology 32 years experience

Pacer life: Pacemakers should be interrogated regularly in a pacemaker clinic and one of the parameters tested is battery life.

1.4k viewsAnswered >2 years ago

A 40-year-old member asked:

Is it normal to get varicose veins?

Phlebology 32 years experience

Varicose veins: Varicose veins are not normal but have increased prevalence with aging and sedentary lifestyles. Targeted leg exercises and strong calf muscles reduce... Read More

1.5k viewsAnswered >2 years ago

A 30-year-old member asked:

Is the evlt procedure for veins painful?

Phlebology 32 years experience

No. EVLT not painful: The procedure may be uncomfortable as it involves using local and tumescent anesthesia. However, most people state that the degree of pain and discomf... Read More

1.5k viewsReviewed >2 years ago

A 37-year-old member asked:

Hemorroids or clot in vein. which is hard?

Phlebology 32 years experience

Thrombosed hemorrhoi: Hemorrhoids can thrombose and such thrombosis can be painful, especially if they are external. i.e. external hemorrhoids. Internal hemorrhoids are rar... Read More

1.4k viewsReviewed >2 years ago

Dr. Jayshree Chander agrees1 doctor agrees

A 42-year-old member asked:

Will ditropan (oxybutynin) stop my heavy axillary sweating?

Phlebology 32 years experience

Glycopyrrolate: In my large hyperhidrosis practice, I find the best oral anticholinergic medications to be glycopyrrolate and oxybutinin, in that order. The Center fo... Read More

1.4k viewsAnswered >2 years ago

A 51-year-old member asked:

Do cysts go away on their own?

Phlebology 32 years experience

Cysts: Cysts that have developed an epithelial lining are not likely to go away spontaneously as this tissue layer secretes body fluid.

1.4k viewsAnswered >2 years ago

A 42-year-old member asked:

Accidentally bent my finger and now it''s swollen. what should i do?'

Phlebology 32 years experience

Finger trauma: It is best to get an xray of the finger to make sure there is no fracture.

1.4k viewsAnswered >2 years ago

A 22-year-old female asked:

What treatment is best to totality eliminate axillary hyperhidrosis?

Phlebology 32 years experience

Axillary sweating: Botox will treat axillary hyperhidrosis for 3-4 months. miraDry is very effective in treating axillary hyperhidrosis.

1.4k viewsAnswered >2 years agoMerged

A 47-year-old member asked:

How do class iii elastics work?

Phlebology 32 years experience

Class III stockings: Compression is the way they work, stopping the pooling of blood in the legs. Class 3 is 30 - 40 mm Hg.

1.4k viewsAnswered >2 years ago

A 31-year-old male asked:

Importance of barely elevated d-dimer (101ng/ml with ref range .01-100) w/ normal cbc, inr, pt, appt? no pe/clot. 4lb weight loss. cancer likely?

Phlebology 32 years experience

Cancer and D-Dimer: Anything is possible and therefore you need to see your primary care physician for evaluation. D-Dimer is not sensitive test for any one particular pr... Read More

1.4k viewsAnswered >2 years ago

6 thanks

A 21-year-old female asked:

D dimer 0.55, chest & pain (right&left for both), ctw/contrast was normal. could i have a blood clot or pe? if not, what's causing this pain?

Phlebology 32 years experience

Borderline d dimer: D-dimer units (DDU) (< or =0.50 mcg/mL fibrinogen equivalent units: FEU) are normal. D-Dimer is a nonspecific test and the good news is that CT an... Read More

1.5k viewsReviewed >2 years ago

Dr. Kenny Chuu agrees1 doctor agrees

A 18-year-old female asked:

Can thoracic outlet syndrome ever become a serious issue?

Phlebology 32 years experience

TOS: There is neurogenic, arterial and venous types for TOS. Some that cause arterial or venous obstruction can cause arterial insurfficiency of the upper ... Read More

1.4k viewsReviewed >2 years ago

Dr. Evan Altman and another doctor agree2 doctors agree

A 37-year-old female asked:

My dad has 2-3 blocked arteries 90% and 1 100% had minor strokes and heart attacks having forced surgery on fri, he has not been good what r the risks?

Phlebology 32 years experience

CABG risk: It is not clear from your description what type of surgery he is getting. I surmise that you mean coronary bypass surgery. Overall risks for patients ... Read More

1.4k viewsAnswered >2 years ago

A 33-year-old female asked:

Been obsessively checking my blood pressure (50+ times a day). will this do any damage to my arm/arteries/etc? arm feels slightly sore now.

Phlebology 32 years experience

BP measurement: There is no need to obsessively check your blood pressure. I am giving you this advice as a CV surgeon. Meaasuring your blood pressure if you have hyp... Read More

1.4k viewsAnswered >2 years ago

A 20-year-old male asked:

I have a tender spot in my right legs hamstring. the spot feels a little cool after rubbing it. pulled/torn muscle?

Phlebology 32 years experience

Hamstring pain: The hamstring in the posterior thigh can be tender for many reasons. If it does not improve, a B mode ultrasound study will be helpful in delineating ... Read More

1.4k viewsReviewed >2 years ago

Dr. Kenny Chuu agrees1 doctor agrees

A 17-year-old male asked:

Are there any creames for groin hyperhidrosis? truncal as well?

Phlebology 32 years experience

Hyperhidrosis Groin: The products I would recommend for the groin area in regards to hyperhidrosis would be 3% gycopyrrolate or 21% aluminum chloride.

1.5k viewsAnswered >2 years ago