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Doctor insights on: Dr Mo Li

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Passing gas: since apr/13, my volume is up 200-400%. High fiber diet. Lithium toxicity undiagnosed 5 yrs. Dosage lowered to 450mg 6 mo's ago. Related?

Passing gas: since apr/13, my volume is up 200-400%. High fiber diet. Lithium toxicity undiagnosed 5 yrs. Dosage lowered to 450mg 6 mo's ago. Related?

Not from Lithium: Your increase in flatus is more likely due to your high fiber diet, rather than lithium. Lithium can cause diarrhea ; loose stools in 20% of patients. That said, high fiber is healthy for your bowels. As long as it's coming out, the gas will not harm you. You could avoid gas-forming foods like broccoli, beans, onions, fermentable fiber, lactose, etc, for a couple of weeks ; then test 1 by 1. ...Read more

Lithium (Definition)

Chemically, lithium is a light, soft, alkali metal. It's very highly reactive, so that in nature it's only found in compound form. It's useful in batteries. As a medication, Lithium Carbonate and citrate can be used to stabilize mood in people with bipolar disorder. In these people it can help with both mania and depression. Blood level monitoring is ...Read more


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I ve had high temps every 2-3 mo. For the past year. No history of travel. History of whipples proc. In 03. They last 1-2 days. I've seen 2 dr. With no answers.?

I ve had high temps every 2-3 mo. For the past year. No history of travel. History of whipples proc. In 03. They last 1-2 days. I've seen 2 dr. With no answers.?

Ask Infectious Dis.: Fever like that requires cultures when the fever is at its maximum. Document ur temp. On a calendar. We have to rule out causes of fever of unknown origen: infections (abscess, cholangitis), cancer (lymphoma and others)recurrence of cancer if the whipple procedure was done for that, collagen vascular disorders (systemic lupus, rheumatic arthritis, vasculitis) fever from antibiotics. Get i.D. ...Read more

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My dr wants. To lower my dilaudid dose from 240 tablets/mo to 120 by my next script. Isn't this negligent? I will get sick and be in more pain.

My dr wants. To lower my dilaudid dose from 240 tablets/mo to 120 by my next script. Isn't this negligent? I will get sick and be in more pain.

Diluadid taper: That seems a bit rapid a wean. Did he/she propose a taper schedule. If not - I would ask for one. Is there a reason they are weaning you??? Its not negligent if he/she explains why and proposes a tapering schedule. Good luck ...Read more

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I have seen a GI dr for 4 mo w/o results, are there many GI problems hormonally related? My symptoms keep changing, which specialist do I need?

I have seen a GI dr for 4 mo w/o results, are there many GI problems hormonally related? My symptoms keep changing, which specialist do I need?

Many more factors: If you have seen GI doctors and done endoscopy or colonoscopy and did not find any problems, then it could be due to due to hormonal or psychological or so many other things. You might wanna read about irritable bowel syndrome if this fits your symptoms. Some people get changing symptoms due to stress as well. ...Read more

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I went from 1mg 2xday Xanax (alprazolam) 9 mo to 1mg for 5 days a half 5days tom 2/23 I do a 1/4 7 days n done my dr said ok but will I feel better when done?

I went from 1mg 2xday Xanax (alprazolam) 9 mo to 1mg for 5 days a half 5days tom 2/23 I do a 1/4 7 days n done my dr said ok but will I feel better when done?

Not clear: I'm having trouble following you. But if you're tapering off on your xanax (alprazolam) dose, that's laudable. It tends to be hard to do if you go faster than about. 5 mg decrease every 2 weeks. It may be easier if you're also on another anti-anxiety medication (non-controlled) at the proper dose. ...Read more

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What do I do, when every dr. I've seen can't figure out what's going on with me?? (FYI- I have multiple health problems already...& I do see a couple world-renowned specialists). & now my labs are not making a lot of sense to them. I'm suffering a lot mo

What do I do, when every dr. I've seen can't figure out what's going on with me?? (FYI- I have multiple health problems already...& I do see a couple world-renowned specialists). & now my labs are not making a lot of sense to them. I'm suffering a lot mo

Alternative Medicine: Suffering female has world-class physician specialists stymied; so rational therapies forestalled. Might be time to consult world-class practitioners of Alternative & Complementary Medicine. Mind, brain, nerve, immune & endocrine systems interconnected. Intricate dysfunctional relationships not always measurable. Modified behaviors, attitudes, exercise & nutrition can rebalance complex functions. ...Read more

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For several years I sometimes get debilitating cramps during sex. Prev dr never found cause. 8 mo after baby, its back. So random. Thoughts?

For several years I sometimes get debilitating cramps during sex. Prev dr never found cause. 8 mo after baby, its back. So random. Thoughts?

Cramps during sex: I had a patient that had cramps after sex that were due to the prostaglandins in the ejaculate. Her pain was better taking advil (ibuprofen) an hour before sex. There could also be an organic cause, so I would see a gyn to rule that out. Also if you do not have these cramps when pregnant, then a birth control pill may do the trick. I hope this helps you some. These are just thoughts. ...Read more

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In Nov, my fasting BG was 100. Now it's 72. For past mo, I've had hypoglycemic symptoms. Dr said its normal but I don't feel normal! Suggestions?

In Nov, my fasting BG was 100. Now it's 72. For past mo, I've had hypoglycemic symptoms. Dr said its normal but I don't feel normal! Suggestions?

Probably OK: While it is not clear why your fasting BG has changed so much in 8 months, 72 is a good level which should not concern you. It's important to know what your hypoglycemic symptoms are (sweating and feeling shaky are the most common) and when they occur. If they occur 3-4 hours after a high carb meal and resolve with eating you likely have post-prandial hypoglycemia - annoying but not serious ...Read more

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I have a 9 mo. Who had his circumcision adhere & 2wks ago a dr pulled it down. It readhered & was told to leave it, pull down, or surgery. Advice?

I have a 9 mo. Who had his circumcision adhere & 2wks ago a dr pulled it down. It readhered & was told to leave it, pull down, or surgery. Advice?

Leave or pull.......: You can leave it alone, as most of the adhesions will release on their own as the child gets older or gently pull down on the foreskin remnant--not causing any discomfort to the child--with every diaper change until the adhesions release. Either decision is correct. ...Read more

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How long can lymphatic colitis last? I've had it for 6wks. My gastro dr. Didn't give much help. I get it every 3 mo. But it has never lasted this long.

How long can lymphatic colitis last? I've had it for 6wks. My gastro dr. Didn't give much help. I get it every 3 mo. But it has never lasted this long.

Lymphocytic colitis: Makes sure you are not on any inciting medications (see list below) and Would call your doc/a doc and discuss the persistence and ask if antibiotic therapy or other therapy or colonoscopy is warranted at this time

http://www. Niddk. Nih. Gov/health-information/health-topics/digestive-diseases/microscopic-colitis/Pages/facts. Aspx ...Read more

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How long does it take to lower hgb? Mine was slightly high, my dr said drink more water & recheck in 3mo. But I forgot. Should I go in 3 mo. From now?

How long does it take to lower hgb? Mine was slightly high, my dr said drink more water & recheck in 3mo. But I forgot. Should I go in 3 mo. From now?

Anytime: Make sure you drink enough water so that your urine is colorless. You may repeat the test any time it is convenient.
For good health - Have a diet rich in fresh vegetables, fruits, whole grains, low fat milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco, alcohol, weed or street drugs in any form.
Practice safe sex.
Get HPV vaccine. ...Read more

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My son is 4 mo old and has been told by his Dr to drink pedialyte. How much a day should I be giving him? Iv been giving 6 oz along w/ normal feedings

My son is 4 mo old and has been told by his Dr to drink pedialyte. How much a day should I be giving him? Iv been giving 6 oz along w/ normal feedings

Ask your doc: For what reason were you told to start pedialyte for your baby? As your pediatrician made the recommendation, and is also the person who knows your baby and his issues, your pediatrician is the best person to answer this question. Generally speaking, at 4 months formula alone is fine. ...Read more

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How slowly should I reduce my dose of Zoloft (sertraline)? On 200mg for 11 years and Dr wants me to reduce to ideally 100. Advises reducing 50mg/mo. Too fast?

How slowly should I reduce my dose of Zoloft (sertraline)? On 200mg for 11 years and Dr wants me to reduce to ideally 100. Advises reducing 50mg/mo. Too fast?

SSRI Discontinuation: SSRI discontinuation syndrome can occur from too rapid a taper. Symptoms may consist of "brain zaps", flu-like symptoms and depression. Going slowly is the key and approach should be individual. A reasonable approach is to reduce the dose by 25 or 50 mg every 2-4 weeks. If symptoms occur, slow the taper by half, and a temporary increase in dose can produce rapid resolution of symptoms. ...Read more

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Sister is 6 mo. Preg saw dr. Said her uteris is lrg the baby has grown a lot has way 2 much fluid, specalist never called today?

Sister is 6 mo. Preg saw dr. Said her uteris is lrg the baby has grown a lot has way 2 much fluid, specalist never called today?

Numbers: At 6 months, reason for concern would be if the baby was measuring > 2 weeks bigger than it's due date. Also, it's helpful to know how much fluid is 'too much'. Polyhydramnios happens at 20-25cm of fluid. Sometimes this can be due to diabetes, other times due to blockages in baby. Most important is to find out what cause of excess fluid may be. She may or may not need specialist --> answers. ...Read more

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2nd mo I've spotted a week before period due, last mo had a dr visit couldn't find anything wrong. Should I let my dr know it happened again?

2nd mo I've spotted a week before period due, last mo had a dr visit couldn't find anything wrong. Should I let my dr know it happened again?

Cycle control: Irregular periods are one of the most common problems obgyns treat. If this is one time problem it usually resolves on its own. If this is a recurring problem you should be evaluated. There are multiple options for cycle control. Hormonal treatments such as birth control pills, Progesterone treatments and the Mirena (levonorgestrel) iud are effective reversible treatments that will help many people. ...Read more

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My 4 mo old is starting to clamor for solid food. I want to wait til 6 mos per our dr...Any tips on reducing his frustration while stalling him?

My 4 mo old is starting to clamor for solid food. I want to wait til 6 mos per our dr...Any tips on reducing his frustration while stalling him?

4-6 mo is fine: Solids can be given anytime between 4 and 6 mo of age. That said, 6 mo is better as the tongue extrusion reflex is gone. Most parents wind up giving solids around 5 mo when their children are really intently wanting the solids and the tongue reflex is gone. You can always spoon formula or milk, so he gets used to having solids given that way. Cereal is pretty soupy at the beginning anyways. ...Read more

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Dr mistakenly gave tdap shot twice, 2 weeks apart to our 2.5 mo old. What can happen, side effects?

Dr mistakenly gave tdap shot twice, 2 weeks apart to our 2.5 mo old. What can happen, side effects?

Unlikely to be a pbm: The good news is has not been shown to cause problems even when doubled up. The bad news is baby likely won't get much added benefit from the shot. When given closer than 6 wks apart it does not seem to provide an added benefit. ...Read more

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Dr wrote 3 mo scrip for nexium (esomeprazole). Is that considered "chronic" use that could lead to gastric lymphoma?

Dr wrote 3 mo scrip for nexium (esomeprazole). Is that considered "chronic" use that could lead to gastric lymphoma?

Nexium (esomeprazole): I can remember when people use to worry about these things when the medication first came out. There as been so much use now that we know there is little to worry about and it is common use to give people 3months at a time on their medications. ...Read more

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My 2 mo old has very dry scalp, and she is always scratching it so she looks like she has dandruff. What could it be? Her dr. Says nothing...

My 2 mo old has very dry scalp, and she is always scratching it so she looks like she has dandruff. What could it be? Her dr. Says nothing...

Cradlecap: Initially you may try using baby oil and let it soak for a couple of hours on your babies head, and then scrub it off.
You may also use head and shoulders or selsum blue, 3 x a week to see if helps (just don't get in eyes),
if not helping a prescription of Nizoral (ketoconazole) shampoo, 2-3x a week for a month and then periodically. ...Read more

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I'm suffering from chronic diarrhea for 9 mo. Lost 30 lbs. Tests are normal. Dr. Says allergy but don't know what. Don't know what to do. Help pls.

I'm suffering from chronic diarrhea for 9 mo. Lost 30 lbs. Tests are normal. Dr. Says allergy but don't know what. Don't know what to do. Help pls.

Diarrhea and allergy: If you already see a gastroenterologist. If all infectious, hormonal etiologies have been ruled out and your doctor see a lot of eosinophilic infiltration in your gut, you might have a type of food allergy that causes severe diarrhea called eosinophilic gastroenteritis. If this is the case, you might need to be on elemental diet. Allergist physicians like us treat this condition. ...Read more

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A1c n creatinine serum tested 5.7, 1.37. Dr. Wants to wait 6 mo n repeat test. Could it be something besides diabetes? Can it be a false? Diet is good

A1c n creatinine serum tested 5.7, 1.37. Dr. Wants to wait 6 mo n repeat test. Could it be something besides diabetes? Can it be a false? Diet is good

Pre diabetes.: A1c 6.4 / 6.5 and more = diabetes.
If u are overweight work on it.
A1c repeat is fine in 6 months.
Serum creatinine I can not comment as each lab has different norms for creatinine. ...Read more

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What or where is sphincter of odis? Had gallbladder removed 1 mo ago now excruciating pain. Had ultrasound dr thinks its the odis sphincter

What or where is sphincter of odis? Had gallbladder removed 1 mo ago now excruciating pain. Had ultrasound dr thinks its the odis sphincter

Common bile duct: The sphincter of oddi is at the bottom of the common bile duct, which empties into the second portion of the duodenum. It can be a source of discomfort, and the pressure can actually be measured my manometry. I'd back off to a lower fat diet, and recheck your liver fuctions. If this persists, you may require endoscopy for evaluation. Good luck. ...Read more

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Healthy 21 mo old noticed for 2 dys she has puffiness under both of eyes under lash line. Has not been sick or noticeable congestion. .. Dr or wait?

Healthy 21 mo old noticed for 2 dys she has puffiness under both of eyes under lash line. Has not been sick or noticeable congestion. .. Dr or wait?

Depends: If the puffiness is red and tender to touch, you should take her in. If it's just puffy and she doesn't have any other symptoms I would just monitor for fevers or other signs of illness. ...Read more

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I suffer from GAD/DEP. I was on Effexor (venlafaxine) XR for 6 mo. And it stopped working. Dr. cross tapered me to Prozac and now it does not work after 6 weeks.

I suffer from GAD/DEP. I was on Effexor (venlafaxine) XR for 6 mo. And it stopped working. Dr. cross tapered me to Prozac and now it does not work after 6 weeks.

Sounds like you: Should review this with your prescribing physician, as he/she may need to increase your Prozac (fluoxetine) dose or consider treating you as a "treatment resistant depression". This may require "combination" therapy to allow for improved control. Additionally, you may require the help of a psychiatrist to help guide therapy, if not already the case. ...Read more

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Pediatrician advised that my 20 mo old take childrens allegra (fexofenadine) everyday, but directions say under 2 ask a dr- what dose do I give her? She's 30 lbs

Pediatrician advised that my 20 mo old take childrens allegra (fexofenadine) everyday, but directions say under 2 ask a dr- what dose do I give her? She's 30 lbs

15-30mg at 2x/day: Allegra (fexofenadine) is typically not used for kids under 2, unless child has chronic urticaria (hives) in which this med is used down to age 6 months. Usual dosage for age 6mon-2 yr is 15mg at 2x/day. Age 2-11 is 30mg at 2x/day. Your child is 30lbs and close to 2, I would say anywhere between 15 to 30mg taken 2x/day is reasonable. Consult doc. Good luck. ...Read more