Flory Fernanda

perpetual student 👧🏻💫

[Flory Fernanda @ffcalix]

@etheprimalbeing Fan #1

[Dr. Otorringolingolingolo @PartesGrandes]

Como me emputa que le digan a los niños que el doctor les va a poner una inyección si no se comportan.
Mames, los doctores ni inyectamos, váyanse alv.

[jillian 🪷 @coykoii]

this evolution is really that serious to me

[Flory Fernanda @ffcalix]

Soju, ver voicemails for isabelle siendo roomie de tu mejor amiga después de dos años de estar long distance; life is good❣️

[Hans Collin @HansCollin2]

Jueves de educación médica.

Nico, 7. Sus padres te consultan porque tiene baja estatura —los dos son relativamente altos.

Durante el examen físico notas que tiene escoliosis torácica y 10 de éstas manchas en la piel.

Enseguida miras sus axilas y se aclara todo.

¿Qué viste?
🧵

[DocXus @docxusofficial]

A 2 year old in the US was diagnosed with a disease from the 1700s

He was brought to the ER because he stopped walking.

No trauma. No fall. He just slowly stopped bearing weight on his legs over 6 weeks until he was crawling instead of walking.

His gums were swollen and bleeding. He had a rash. Pinpoint bleeding under his skin. Pain in both legs. Decreased muscle tone.

He kept his legs in a frog leg position and screamed when anyone touched them.

The doctors suspected everything.

First visit: possible fracture. Orthopedics recommended repeat imaging. Four weeks later he was worse.

Second visit: concern for leukemia. Then concern for nonaccidental trauma. Child protective services was called.

Then the workup began

> CT scan of both legs. No fracture.
> MRI of head and spine. Normal.
> lumbar puncture to rule out Guillain Barre. Normal.
> inflammatory markers. Normal.
> muscle enzymes. Normal.
> heavy metal screening. Negative.
> vitamin D and B12. Normal.
> bone marrow biopsy to rule out cancer. Normal.
> electromyography. Normal.
> muscle biopsy. Normal.

Weeks of testing. Multiple hospital transfers. Invasive procedures on a toddler. His parents watched their child get poked and scanned and biopsied while nobody could tell them what was wrong.

Then someone asked the right question.

What does he eat?

Chocolate milk and graham crackers. That was his entire diet. His mother had mentioned he was a picky eater at the very first visit. Nobody followed up on it.

His vitamin C level came back at less than 0.1 mg per deciliter.

He had scurvy.

The same disease that wiped out entire ship crews during the Age of Exploration. The same disease the British Navy solved in 1795 by issuing lemon juice to sailors.

Scurvy impairs collagen production and compromises blood vessel integrity. That explains the bleeding gums. The rash. The periosteal elevation on MRI. The bone pain. The inability to walk.

Every single symptom pointed to one thing and it took months to get there.

He was started on vitamin C supplements. Within a week he was moving his legs again. At 4 months he was walking and his hemoglobin was normal.

The entire workup could have been avoided with one detailed dietary history at the first visit.

We have MRIs and bone marrow biopsies and genetic panels. But the most powerful diagnostic tool in medicine is still asking a parent what their child eats for dinner.

All that extensive workup could’ve been replaced by a 5 minute conversation about food.

[Pilara @youfavlovaa]

hacer que una persona se sienta amada es más importante que decirle que la amas.

[Flory Fernanda @ffcalix]

@DiyinaJones Se van a penales con la de daphne💃🏻

[Flory Fernanda @ffcalix]

@gustavo7castel “De la tiendita”

[Flory Fernanda @ffcalix]

@gustavo7castel Y serias el más top🤩

[Flory Fernanda @ffcalix]

@ErnestoLainez9 Dele 0/20🤣🤣🤣

[Flory Fernanda @ffcalix]

@ejrgtheprimal Podes ir los fines de semana🫶🏻

[Flory Fernanda @ffcalix]

@ejrgtheprimal JAJAJAJ

[Mario Hernández @Mario_H28]

Salvador Nasralla, ¡el único ser humano en ganar 3 presidencias y nunca ser presidente!
Le ganó 2 veces a Juan Robando (activaron votos rurales), hizo ganar a la vieja Chancluda en 2021 y ahora le ganó a Nasry Asfura (se cae el sistema mientras Honduras dormía y regresa con “Papi punteando”).

No quieran jugar con la inteligencia de los hondureños; los que realmente queremos un cambio verdadero, ¡NO SOMOS PENDEJOS!

¡Salvita, lo intentaste! No te merecemos.
Serás recordado como el prócer que quiso sacar a su país de la mierda y el mismo pueblo te lo impidió, por la ignorancia de seguir partidos tradicionales compuestos por impíos avaros, sedientos de poder.

Facundo Cabral:
“Ténganle miedo a los pendejos, porque son muchos y pueden elegir un presidente”.

[Flory Fernanda @ffcalix]

5 adolescentes en moto, 4 tec leves, 1 tec severo con clínica de hipertensión endocraneana, todos de 14-15 años. ¿Cuándo van a implementar leyes que penalicen a los papás irresponsables?

[Brigitte Calderón @Bcbrigitte]

Mood de hoy

[timepass @geeooddee]

a good doctor never encourages others to become a doctor