This updated article clarifies practical steps across four areas: successful weight gain requires a calorie surplus, adequate protein (about 1.6-2.2 g/kg/day), and resistance training; leukocytosis with renal colic calls for urinalysis, culture, and urgent antibiotics plus drainage if infection and obstruction are present; panic attacks respond well to CBT and paced breathing with medication options as adjuncts; Fabry disease is an alpha-galactosidase A deficiency treatable with enzyme replacement therapy or migalastat for amenable mutations, with gene therapy under investigation.
Fuel and exercise for healthy weight gain
If your goal is to gain weight, exercise alone won't be enough. You need a sustained calorie surplus and adequate protein to build lean mass. Current recommendations for muscle growth support roughly 1.6-2.2 g of protein per kilogram of body weight per day, combined with a progressive resistance-training program. Focus on compound lifts (squats, deadlifts, presses), steady progression in load, and 48-72 hours of recovery per muscle group. Limit excessive aerobic training while prioritizing sleep, regular meals, and energy-dense, nutritious snacks.
When a high white blood cell count matters in suspected renal colic
Flank pain that suggests renal colic often prompts imaging and a urinalysis. An isolated mild leukocytosis can reflect pain or stress, but signs that suggest infection include fever, positive urine nitrite or leukocyte esterase, bacteriuria on dipstick or microscopy, systemic signs of sepsis, or impaired renal drainage on imaging. An obstructing stone with suspected infection is an emergency: these patients need prompt antibiotic therapy and urologic decompression (stent or nephrostomy). In stable patients without infection signs, antibiotics are not routinely required; obtain urine cultures and follow clinical status.
Panic attacks: brief, treatable episodes
Panic attacks are sudden episodes of intense fear or discomfort that peak within minutes and often resolve within 20-30 minutes, although residual anxiety can last longer. Cognitive behavioral therapy (CBT) is first-line for recurrent panic, teaching patients to recognize triggers, reframe catastrophic thoughts, and use paced breathing and grounding techniques. Short-term medications (e.g., benzodiazepines) may help for acute relief, while SSRIs or SNRIs are options for longer-term management. Seek urgent care for new chest pain, fainting, or neurological symptoms to rule out other causes.
Fabry disease: targeted treatments and what to expect
Fabry disease is an X-linked deficiency of alpha-galactosidase A that leads to accumulation of globotriaosylceramide (Gb3) in blood vessels, kidneys, heart, nervous system, skin, and eyes. Treatment options have expanded since the 2000s. Enzyme replacement therapy (ERT) with recombinant alpha-galactosidase reduces substrate accumulation and can slow organ damage. For patients with amenable GLA gene variants, the oral chaperone migalastat offers an alternative. Gene therapy approaches are under investigation in clinical trials. Management also requires multidisciplinary monitoring of renal, cardiac, and neurologic function.
Practical takeaways
- For weight gain: prioritize a calorie surplus, 1.6-2.2 g/kg/day of protein, and progressive resistance training.
- For suspected infected renal colic: look for fever, positive urinalysis, or obstructing stone - these require antibiotics + urologic drainage.
- For panic attacks: CBT and breathing techniques are effective initial treatments; medications can be adjuncts.
- For Fabry disease: ERT and migalastat (for amenable mutations) are established therapies; gene therapy is experimental.