Singelli had a lot of great points in her post, so I'd like to piggyback off her as well as what I tell my patients when I'm in the office.

First, you have to realize this will be a long process. You didn't gain all your weight over a week or two, so it isn't going to be quick. In general, a healthy amount of weight loss is only about 2 pounds a week. That's it. So how do you approach this.
In the medical literature, all of the different diet fads have been studied and compared all of them to each other. NONE of them were found to be better than any other. So the key really is to figure out what is best for you. Most people think they need to change everything at once, which is something you'd never stick to once you're diet is over. You have to approach this as a lifestyle change.

First, just start with cutting down your portion size, then from there start figuring out where you can start eating healthier. Don't force yourself to eat celery 24/7, find what you like, and start there. Like Singelli and a few other people said, counting calories is not a bad idea. Now, you don't necessarily have to do this forever, do it for 3-4 days where you don't change your normal diet to get a good baseline. There are about 3,500 calories in one pound, so that'll give you an idea of how much weight you're putting on with a few meals.

A big change you can do that will go a long way is to limit carbs (breads, pastas, etc..) There was a study in the most recent New England Journal of Medicine, one of the most prestigious medical journals, comparing low carb diets vs low fat diets. 2 groups of people were followed over a 1 year period on these specific diets. Over a 12 month period, the low carb group on average had lost 9 pounds more than the low fat diet. This is a great guide to follow.

Remember how I said this is a lifestyle change? Not only must you commit to a diet, but also you need to exercise almost daily.  You need to commit to this seriously. The American Heart Association recommends for both weight loss and cardiovascular benefit, working out 5-6 times a week for 30 minutes. For this, you don't need to be running marathons. Go for a walk, bike ride, yoga, anything like that, but find out what you enjoy and go from there. Personally, I put on music and jog, I get lost in my music to have a great time and block out the work I'm doing. The 30 minutes do not have to be at one time either. If you need to start at 3-10 minute intervals, that's outstanding.

Now, look at how much info is in this post. This is definitely more than I can provide in a single visit with a patient. What this does is, hopefully, emphasize what the commitment needs to be. You can absolutely do it, and after reading your post, I absolutely believe you can. you need to go into this with a plan, and stick to it. Figure out what you like, and incorporate it. If you aren't enjoying yourself, how can you possibly stick with it? Remember, any effective/permanent weight loss program has only been done with a combination of diet AND exercise, not one or the other. 

There are a lot of generalities here, so if you have any specific questions, or any other questions, I'd be more than happy to help wherever I can. If you want some ideas on where to start or anything like that, please let me know as well. Best of luck

thing1 : Singelli: I'm a family doc, and I know you have no reason to believe me on this but there's a few people on this board, like Singelli in this thread, that could probably avouch this for me, but I'll try to clarify all this. 

The concept with the imaging is not that they are "lying". There have been multiple studies and meta-analyses that have shown there is no correlation between MRI findings and degree pain with disc herniations. Meaning, you could have a sever bilateral herniation, or a vertebral disc that is almost non-existent and only have mild to no pain, or have minimal MRI findings and have crippling pain. 

On top of all that, the success rate of improving pain after disc herniations is not statistically significant. This means that if you take a sample of a random group of people and retroactively assess their pain, there is not a measurable difference between the people who have improved pain vs no change in pain vs worsening pain. There is always the risk of paralysis with back surgery as well, because the goal of the surgery is to excise the vertebral disk that is compressing a nerve that is controlling sensory and motor function for parts of the body below that level.

In order, the most effective treatments/therapies for chronic back pain are physical therapy, steroid injections, and surgery, in that order. Physical therapy will re-strengthen parts of your core to take the strain off your back and relieve the spasms that are irritating the nerves, to relieve pain. (IE by strengthening your abdominal muscles, you correct the force vectors from pulling on your back to evenly distribute all the stress you back would be dealing with.)

The steroid injections the doc is referring to are not the steroids that people think of with body builders or the ones that were/are abused in major league baseball. Those are called anabolic steroids, and physiologically work completely differently. The therapeutic injections are corticosteroids. These work to inhibit the inflammatory response around the affected area. The body carries all its healing factors, etc... in the blood, and to heal an area, all this excess fluid gets sent to the injured area due to signals released by the area. With all this extra fluid, comes extra pressure that pushes on all the structures in the area, including the nerves that cause your sensation of pain, causing a vicious cycle of pain, and swelling/irritation. By giving a corticosteroid, this inhibits the cycle to take the irritation away from the nerve to help the pain. This is used all the time, people get these injections in knees and elbows all the time to fix the pain.

So keep all this in mind when you're talking to the specialists. Sure, they may not have great bedside manner and may not explain in detail everything I just attempted to, but there's a process we all follow to decide what will most benefit the patient. If you don't agree with us, you absolutely have the right to at least ask a billion questions or to seek a second opinion. If you can't feel like you can't trust your doctor, you should absolutely find somebody else, because at it's core, the patient-physician relationship is the most crucial thing.

If there is something else I can help clarify, please let me know. Hope this is at least somewhat helpful.

Singelli :  
Sorry I'm late to the party here, but everything you see above here is 100% and they did a great job explaining it. 

The muscle cramps are caused both by the dehydration and low potassium. If you're dehydrated, you'll have a lower blood volume, so your blood will have a more difficult time getting to the deeper parts of your muscle that are the farthest away from your heart (which is why this almost always affects the calf muscles). If the body isn't using oxygen to help produce energy, it changes things around and the byproduct is lactic acid, which once it builds to high levels, elicits that intense cramping pain you get in the middle of the night (ie. Charlie Horse). Since you're sleeping, you don't notice it building up, so you'll wake up in much more pain than during the day when you can feel it coming on.

On top of all that, after the muscles contract, potassium needs to travel back into the muscle cells so you can use the muscle again. If your potassium is low, your muscle cells can't go back to the resting state, which then fatigues the muscle. A fatigued muscle builds up lactic acid at a much higher rate, leading to more muscle cramps.
 
Foods like bananas are certainly the best bet for helping low potassium. For fluids, soda and coffee will make you urinate out excess potassium, so those are big things to limit. Water is great, and you could use sports drinks as well (Gatorade, etc...) but just be careful with those, as lots of those are surprisingly high in calories.

If you have any more questions on all this, I'd be glad to help again. But looks like you got some great people to turn to as well. Well done everyone.

Easy. Air conditioning.

KIDDING! I'd say discovering penicillin/antibiotics, as it allows people to live longer, and for more quality years, regardless of the other technological advances are in the world. There are so many conditions now that we don't even think about  that would kill many people in the past.

Hey to help you guys with this designation, there's an over-simplified formula to use as a general guide. It's called the Body Mass Index, or BMI for short. It has its share of flaws, especially with people who are extremely muscular, and I don't particularly like it either. That said, I do think it's a good start, and helped me to gauge my weight loss when I started to work out harder a few years ago. So the formula is weight/height^2:

kilograms/ meters^2

Or if you use pounds and inches

pounds/inches^2.... and then multiply that answer by 704, which is simply the conversion factor for the units to keep the same scale. And here's that scale.
Under 18 = Underweight
18.5-25 = Normal weight
25-30 = Overweight
30 + = Obese
40 + = Morbidly Obese

For example, Razor-987: is about 18.2, which would just barely be classified underweight. Now does that mean that's unhealthy? Absolutely not, and it could be perfect for his/her size. Another reason why this system can be flawed.

It's a nice gauge to see where you fall, or where you should fall. I used to be in the obese range, now I'm hovering around 25 and trying to break past that theoretical limit, as a personal goal for myself. 

thephantombrain :
I grew up with a NES and SNES so I like to play the games I grew up with as a way to relax de-stress. If I get some time, I like to play the games that make me feel good or I have fond memories of. Loved RPGs like Chrono Trigger and Earthbound but I rarely have enough time to play things that long anymore. Instead I'll gravitate towards games I can play in for a little in a sitting, especially on an NES and games I grew up with, like Ducktales, Castlevania, Kirby, or Megaman. Mostly the classics I guess. 

You all are making me sad with these responses. Makes me feel like I'm going to do something awful someday. I haven't hurt anybody yet, I swear. (Completely kidding here!)

I want to be a doctor when I grow up. And by that I guess that means I'm all grown up in about 9 months or so. I'm currently in my final year of medical school and I'll be graduating this coming June. Sure it's a ton of school, but it's absolutely worth it if you love what you do. Granted, you do go to school for seemingly forever but it really isn't all bad honest. That said, I'll be 28 when I graduate. Then, after medical school you do another round of training, called residency. With this, you do continuing education at a hospital for 3-5 more years, depending on what you'd like to do. This is essentially more learning how to treat and manage patients, with your own workload, etc... and you do procedures yourself, and you're now considered a doctor and are able to write prescriptions and all that, but you get crazy hours and a tiny pay check. I'll go through the schooling aspect after undergraduate (ie. College) education since many people don't seem to fully know how it works. I'm including this here for the people who are considering a career in the medical field, since people who are at least somewhat interested in medicine will be clicking on this thread.

After undergrad, you do 4 years of medical school. The first two years are purely lecture based, where you sit in a classroom and get lectured to for 4 or more hours a day. There are some laboratory and hands on stuff, but that is few and far between early on. First year, everybody will do anatomy lab, where some truly selfless people who passed away donate their body to the school and you dissect it, to supplement your anatomy knowledge to help you understand how the body works, not only in its individual segments, but as a functional unit on the whole. You also get some limited patient experience, but that doesn't happen until your 3rd and 4th year.

3rd and 4th year are spent exclusively in hospitals learning directly from doctors. Generally, you spend 4 week at a time on each service (whether its surgery, O/BGYN, psychiatry, family medicine, internal medicine, etc...) and then move on to the next field, which is often in a completely different hospital. So essentially I've been living out of my car since the beginning of 3rd year because of all the traveling I've done, with ending up in a new hospital after getting comfortable at the previous one. It does tend to wear on you travelling so much, but it really is neat seeing how medicine is practiced in different areas of the state, region, or even country, and you get to meet and work with some great people along the way.

Now, I'm currently applying for residencies which will then complete my training. The work hours are long, and actually a law was passed to keep residency work hours at a max of 80 hours per week because of how much works residents were doing in the not too distant past. I'm looking to go into Family Medicine. I have 3 more years of training, and at that point I'll be a full-fledged doctor and finally out working on my own. It is kind of crazy to me to look ahead at that time and think I'll almost be 32 years old once my training is complete. Other doctors will then go on to specialize at this point, and will do possibly a few more years of training, which is called a fellowship at this point. Now THAT'S a ton of schooling. It takes some motivated people to do that, and I'm not sure I have that sort of motivation in me.

Sure, this all seems pretty intimidating, but it's all worth it in the end. Even in my somewhat limited exposure, I've been fortunate to meet some really great people and do some pretty major things for them. I can't go into specifics due to doctor-patient confidentiality, but it really is humbling to see what you can do for people and huge smile you get afterwards. Even for something so little as taking a few extra minutes to talk to somebody means the world to a patient, and makes you feel great that you've made a positive impact on them.

If anybody here has any questions about pursuing a career in medicine, please sent me a message and I'll be more than happy to give my honest and straightforward opinions on the positives and negatives on my experience so far. If you see any of my posts in the past, they're almost all medically related so this is something I enjoy doing. 

I know this is pretty long winded, but I hope this helps you understand what all goes into school and training, and possibly even light a fire under you if you think this is something you could potentially doing as a gratifying career for yourself. Sure the training and amount of schooling it takes to complete the training seems daunting, but I could not possibly see myself doing anything else. Hope I didn't bore you too much and I look forward to answering any questions any of you may have.

Singelli :
rcarter2 :

He did a great job describing the popping. Fun fact #1) I thought it was neat that the guy who proved you can't get arthritis from cracking your knuckles won a Nobel prize for it. He cracked the knuckles on one hand but not the other for like 50+ years and didn't get arthritis in either hand.

To help with the air/fluid/joint analogy, let's go back to the synovial joint concept. The synovial joint, like rcarter2 explained very well, is a sac that sits within a joint to help the bones glide without touching each other. If the synovial sac shrinks and bones rub on bones, it becomes very painful, and this is the definition of osteoarthritis. 

Now, this sac is supposed to be a definite size and isn't really supposed to get larger. If the sac gets stretched out, the volume in it now becomes a little larger, and this extra volume is filled with air. The synovial fluid surrounds the air, causing bubbles within it, and when these bubbles pop, you get the CRACK sound. Picture something like a latex glove or a balloon. If you push your finger into it, you can create a new pocket that is now filled with your finger. Remove your finger, and the tension in the balloon will snap back to give the balloon it's original shape. Think of that snapping back as the cracking sound your joint makes when the bubbles pop. Let me know if that description helps, or just confused you more.

And for your second question, the body is able to absorb free air and does it all the time. Whenever laparascopic surgery is done (for gallbladder, appendix, hernias, etc...) we pump air into the abdominal cavity and use that air pressure to push all the vital organs and vessels out of the way so we can operate more safely. The patient is bloated that day, but air is re-absorbed in a day or two. Fun Fact #2) the scrotum will appear inflated with this as well, and will also reduce back to normal size after the air is re-absorbed. Multiple body cavities are integrated, and only a nerd/dork like me finds this stuff fascinating/awesome. 

I tend to try and complete as much as possible with the game. If I'm going to pay full price for it, I'm going to try and get my money's worth. Granted, if I tend not to love the game, sure I'll just do my best to just finish the game because, again, I don't want to waste my money, but I won't devote extra time to do everything possible.

Yeah it's definitely frustrating. I get the landlord's side that you're not only paying for a place to live, but also a place to store all your stuff, whether you're there or not. I'm used to working 70-80 work weeks with 12 to 24 hour hospital shifts where I may end up just sleeping at the hospital so paying for an apartment while only using the place 5 or 6 times a week is frustrating. I went with a studio apartment since I'm barely there to make it more affordable, but yeah it sucks.

Yeah I'm guilty too. Getting better, but still a problem. Nails help keep out debris/bacteria from getting into your system. If you bite you nails, you can get a seriously painful infection of the tip of your finger down to your first knuckle, or sore throat from the bacteria entering your throat from the micro punctures the nail makes as you swallow it. Seriously everyone, if you saw any of this stuff in front of you, it'd help you break the habit. I can't throw stones here because I'm guilty as well, but hopefully this helps realize it can be a big deal.

mohammedroxx3 :
There are a ton of good suggestions here that I completely agree with. Finding somebody to talk to, whether it is getting advice, or just somebody that you can vent to can be extremely therapeutic. Also all those suggestions about finding hobbies to break up the day are important to break the cycle of stress/sadness If you can't find something to enjoy, you'll never break out of the cycle.
I've spend weeks rotating through everywhere from free clinics to state mental health institutions talking to people about anything you can imagine. By far, there is one thing I'd HIGHLY recommend to help you get over a situation that is really affecting your mood, whether it's a few rough weeks at work/school, or heaven forbid, something worse like losing a loved one. Cry.
To be able to convince yourself you've emotionally been able to move on from a situation and are now ready to build yourself back up. And I'm not referring to being tearful for a while. I'm talking one of those powerful cries from deep within that can last 5 or 10 minutes. This doesn't have to be while talking with someone, but can be when you're just sitting by yourself and you let everything out. By doing this, your accepting your emotions, and the situation overall, and you can now move on. It takes a stronger person to realize your emotions than being the "tough guy" and holding your emotions in. Believe me, the medical literature supports this, and I've seen it first hand on multiple occasions. Showing emotion is part of human nature, and accepting this is the key to getting over any situation.

Being older than most people (it seems) that post on these forums, it was a joy to come on and play all the Nintendo games I grew up with and re-live parts of my childhood when I'd get together with my friends and just play and laugh all day. It's a cool feeling playing some levels again in certain games and it FEELS the same as I did 10 years ago.

As for the forums, I enjoy going on to some of the forums where I have some knowledge or expertise in and helping people out. Sure it probably only has a minimal effect, but I hope it's doing at least something for people.

A user of this :
Hahaha that's awesome, you can always find a good Greek family selling a quality gyro at state fair. I feel like it's some sort of law at times. If you want to try out some Greek food when you get a chance, grape leaves are pretty mild and a good thing to try out. Any type of lamb is usually a really big hit. Spanikopita (aka "spinach pie") is usually one of our top sellers too - it's thin fillo dough with spinach and feta cheese.

By far the most famous food is baklava - the same fillo dough with walnuts in the middle, covered in a honey/cinnamon syrup. It's absolutely amazing, and highly recommended.

Singelli :
This post just nails it. Too much caffeine is horrible for you, regardless of age. You won't see any studies on its effect on adults or children because the design would basically have to be "here's a ton of energy drinks, drink it all so we can see if you get seriously sick or die from it" Excess caffeine can be toxic to the heart, but you really have to drink gallons of it, but high caffeine intake will cause high blood pressure, sleep disturbances, and most commonly, chronic headaches. I want to stress the sleep disturbance because it really isn't common knowledge how long it stays in your system. Regardless of how much is in your system, your liver can break down exactly half of it every 6hours. So for example, you drink an energy drink after school/work. Most have the caffeine equivalent of at least 2, usually 3 cups of coffee. So if you have one at 5 PM, you still have the equivalent of 1.5 cups of coffee (+100 mg of caffeine or more) still in your system at 11PM. Naturally this can affect sleep. And when kids are still growing, the proper amount of sleep is critical in development.

So with all this said, sure kids should take responsibility for their health, its a part of growing up. But should it be banned because parents are letting them have drinks like this? Absolutely not it shouldn't be banned. Parents should understand the risks, be educated, and at the very least, just use some common sense.  Take a few seconds and think about what  they do, and your kid's overall health, that really shouldn't be too much to ask.

/end rant

Way biased here, but absolutely love Greek food myself.  I'm of Greek descent myself so I grew up with it and have spent multiple summers cooking it for food festivals. I can eat grape leaves (leaves rolled up with rice and ground meat inside) like they're candy. But as for the most famous stuff, the pastries, and specifically baklava, is just magical.

Singelli :
I'm going to follow up this point, because it is crucial (and great insight on your part). No two people will ever have the same exact injury/illness. While the diagnosis may be the same, how it affects people individually is completely different. If you're ever unsure, see a doctor. If you go back and read any of my posts in any of the health threads, you'll see I never say "you have _____, and this is what you need to do". All I'm doing is (hopefully) providing some background info wherever I can. If you're concerned, make an appointment with your doctor. The best doctors in the world will not diagnose/treat you over a message board or a phone call - it's understood how dangerous this can be without a full physical exam.

Singelli :
If you're willing to have me break something else down for you, I can help add a few things. First, what do you really mean by "fainting spell"? Because medically that may mean something different than you're implying. When you have one of these episodes, is it a complete black out where you lose complete consciousness for a few seconds to minutes, then you wake up weak and confused? Or is it more you feel really tired, then all of a sudden you wake up in the middle of what you were previously doing? Does anybody else in the family have this happen to them? And finally, is there anything that triggers this than you can specifically identify (you don't sound too convinced about sleep), or is it entirely unpredictable?

What I'm trying to tease out if this is a true syncopal episode, which is the fancy medical term for passing out. With a true episode, the "blackout" occurs with the person falling. It can be a sign of multiple disease pathologies, but this is more common once you reach senior citizen ages. That said, 50% of all syncope never is never figured out what the cause is, regardless of all the medical testing available. The one thing I'm trying to ask about with these symptoms is whether it is some form of seizure activity. Most people think seizures are just where people black out and the body starts to shake for a little bit, and lose bladder function at the time. However, there are some forms of seizure that are simply the person looking like they're staring out into space and daydreaming for only a few seconds and go back to whatever they were doing like nothing happened. These are called Absent seizures (pronounced Ab-sawn, think French pronunciation) and commonly seen in school aged children, not people our age.

So in a nutshell, if you don't want to talk about personal stuff like this on a public forum, these are all things to relate to a doctor. It may not hurt to make an appointment and bring it up. They could do some studies to watch how strong your blood flow is, or track the electronic signals through your brain (called an EEG). Certainly not trying to scare here, but just trying to give you some tools to help educate yourself on whether this is something you want to have looked in to. 

Finally, cataplexy is more of a debilitation condition, which would have presented itself in social situations multiple times by now, so I really don't think is something you need to concern yourself with. It's on the same spectrum of narcolepsy, which is randomly just flat out falling asleep due to some sort of cue or stressor. Since people seem to have a rough idea of what narcolepsy is, you can try to compare your spells to that for cataplexy, which really doesn't sound likely in this instance.

Hope you could find this useful, and like always, let me know if you want more info or some clarification.

Davideo7 : Appreciate the summon, sounds like a fun idea. You can see I'm usually good for a massive post here and there but I'm in a busy month now between work and travelling for interviews. I'll do my best to help where I can, but unfortunately I could be disappointing.

Singelli : I'm finishing up medical school now and I'll be starting residency in Family Medicine next year so I deal with this type of stuff everyday. So let me know where I can help. And if I don't have an immediate answer for you, I'm surrounded by plenty of resources to make sure I can get you the answer you're looking for.