Brief Answer: Multidimensional history, team of professionalists Detailed Answer: Good day Miss Dona! My name is Dr S Khan and i would like to help you regarding your worries for your recent ear troubles and vaginal thrush with the very complicated history of cardiac, respiratory , Psychiatric, Gastrointestinal and Genitourinary dimensions.I think age of 22 mentioned is a mistake as 22 is too young to have this complicated aetiology and if its truly mentioned then you need a lot of care for your management which would be a team work of rheumatologists, gastroenterologists, gynaecologists, psychiatrists and cardiologists. Lets start from the Ear troubles. Your ear infection with laryngitis and three weeks of antibiotics which have ototoxic behaviour has compromised your hearing , So my advice visit otorhinolaryngology clinic for hearing assessment and sort out the aetiology for this sudden hearing loss and lets hope it is some thing reversible as a simple wax can cause that for which a little suction would suffice but any how you need Otorhinolaryngologist to see whats going on inside that ear so seek one.As you have erythromycin allergies so these can be allergic when topical too so that angle needs to be explored too. Now the vaginal thrush. XXXXXXX i want you to know every thing about this thrush was innocuous until you mentioned bleeding association, As you are already on OCPs and oestrogen's exposure with bleeding vagina just needs a little more precaution and work up to be on the safer road. Let some good eye of gynaecologist see whats going on there, It can be simple UTI or PID but lets have a little work up to rule out malignancies odds as we can not rule them out once blood is oozing out of vagina. Drink cranberry juices 10-12 ounces a day, good toilet hygiene, post coital hygiene, intra bladder hyaluronic acids instillation and simple antibiotic spectrum with some antispasmodics like phloroglucinols would be suffice if its UTI or PID which i am sure it is. Now the Psychiatric Issue, Dona life is too beautiful to be worried or afraid in it. Try the colours of life. seek a good psychiatric facility help. sign up to some good group therapies, let your inner feelings out, you are not alone in this, seek others company who have issues like these, Get rehabilitational programs for vocation and recreation and start a life with new zeal and zest with no Anxiety , phobias etc. You can do it. Only you matter and you should know it when it comes to life and its enjoyment. Now the PCOS. so for that continue the medicines, but more importantly modify diet and lifestyle, use ADA diet and lose weight or it will be difficult to conceive and you will need a fertility consultant for helping in that regard. Now the faty liver and GERD you need a gastro enterologist, Here are some tips which will help to reduce your GERD complaints. Losing weight (if overweight) Avoiding alcohol, chocolate, citrus juice, and tomato-based products Avoiding peppermint, coffee, and possibly the onion family[8] Eating small, frequent meals rather than large meals Waiting 3 hours after a meal to lie down Refraining from ingesting food (except liquids) within 3 hours of bedtime Elevating the head of the bed 8 inches Avoiding bending or stooping positions above mentioned things will help. Some medicines after gastroenterology opinion will be required if above mentioned things didn't suffice. Now last but not the least, Fibromyalgia You need a constant touch with your rheumatologist for management of these issues.You should know this fibromyalgia doesn't resolve in a day. it will take time and compliance with medicines and dietary and lifestyle modifications to seek results.seek the opinion regarding Diet (eg, promote good nutrition, vitamin supplementation, bone health, weight loss) Stress management Aerobic exercise (eg, low-impact aerobics, walking, water aerobics, stationary bicycle) Sleep therapy (eg, education/instruction on sleep hygiene) Psychologic/behavioral therapy (eg, cognitive-behavioral, operant-behavioral) Vitamins and minerals, Malic acid and magnesium combination, Antioxidants, Amino acids,Herbs and supplements and a lot of medicines from anticonvulsants, skeletal muscle relaxants,antianxiety and depressants and a lot of care. And take care of your asthma, Have continuous compliance with asthma medicines and stay in touch with your pulmonologist for avoiding complications. In Nut shell, XXXXXXX you are the most difficult patient i have seen in my life and i am sorry for having these much issues and facing them, You really are a brave girl and i am proud of you, Keep fighting it. Good Luck Miss XXXXXXX and take some very good care of yourself. If you need any more questions for me please feel free to ask other wise i request you to kindly close the discussion and rate the answer as per your experience. May the odds be ever in your favour. have a very good rest of the day and every day after wards. Regards Dr. S Khan

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Brief Answer: Brave girl needs to care for herself Detailed Answer: Helo again XXXX! I am very sorry for your troubles , One who needs her self a lot of care is caring for others is really a bold move and i really appreciate your efforts for that. But dona you need to do as i directed you earlier to stay safe. You have the right to take care of yourself. With these much troubles you can be on disability list easily . Seek help, you will find anyhow. At least your current fever thrush and expected UTIs and PIDs with that complicated history really needs workup. Dona i wish i could do more for you and i really want to cause you are one brave patient of mine and i think you deserve better care and management.You need rest. Kindly Consider it and follow my advices and tips to keep you safe and better.I will be here for you if you need me for anything else. Other wise dont forget to close the discussion Dear. Yours sincerely Dr S Khan

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