Urologist in CM for bladder nodule

[bamboozled]

I feel I've read countless recommendations over the years for urologists but search is not turning up much now, strangely. ...Just discovered I have a nodule in my bladder (via ultrasound) and wondering who I might bother for further investigation.

 

Cheers, Bam

[lopburi3]

Suspect you did not check the medical section - below is a recommended Doctor in CM.  As one who had serious cancer and bladder removed (5 years ago) believe next step will be the camera insert which is not that painful (mostly full bladder feeling as they fill with water) and may allow them to obtain a sample for biopsy.  It is an outpatient procedure.  In the bad luck event of cancer some can spread rather quickly so time is important.   I used Dr. Charuspong Dissaraan who was working at Bangkok Hospital at the time and highly recommend him.

The following urologists have been favorably  recommended by TV members in the past:

Bangkok
Dr. Viroj Chodchoy at Bumrungrad   - has treated a number of TV members for prostate cancer and other problemshttps://www.bumrungrad.com/doctors/Viroj-Chodchoy  

Dr. Charuspong Dissaraan at Bumrungrad. US trained. https://www.bumrungrad.com/en/doctors/Charuspong-Dissaranan

*Dr. Umaporn Nuanthaisong (female) – Sukhumvit Hospital once a week and also at  Bangkok Hospital and at Chula (try their after hours clinic, 13^th floor) http://www.sukumvithospital.com/en_doctorprofile.php?id=188https://translate.google.com/translate?hl=en&sl=th&u=http:

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=2682&doctor=Dr._UMAPHORN_NUANTHAISONG

//www.chulalongkornhospital.go.th/&prev=search

*Dr. Suntchai Wirotsaengthong – BNH hospital https://www.bnhhospital.com/en/find_doctor/detail/135

* These two have been particulalry recommended for management of chronic prostatitis

 

 

Pattaya

Dr. Pornchai Chayaboon Panyasuppakun, Bangkok Pattaya Hospital  https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=208&depid=28

Dr. Jimmy Kongcharoen Bangkok Pattaya Hospital https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=205&depid=28

 

Chiang Mai

Prof. Bunnakit Lojanaphiwat at CM Ran Hospital, also at Sripat (CMU Hospital) and  he also has his own clinic tel 0818824085http://www.chiangmairam.com/searchdoctor1?major_id=&doctor=103

Edited March 17, 2022 by lopburi3

[bamboozled]

Thanks, Lopburi. I did check that section but the pickings are pretty slim and it's dated. You refer to Bkk hospital in CM, correct? Was Bkk hospital there 5 years ago? My how time passes! I appreciate the info and looking forward to the camera. Fingers crossed it's nothing....ugh.

 

Cheers, Bam.

[lopburi3]

26 minutes ago, bamboozled said:

Thanks, Lopburi. I did check that section but the pickings are pretty slim and it's dated. You refer to Bkk hospital in CM, correct? Was Bkk hospital there 5 years ago? My how time passes! I appreciate the info and looking forward to the camera. Fingers crossed it's nothing....ugh.

 

Cheers, Bam.

No Bangkok Hospital in Bangkok - doctor moved to Bumrungrad Hospital a few months after my operation.  Most likely it will be be nothing but even in the worst case it can most likely be treated so you want to get it checked ASAP.  In my case got bad advise to wait for government hospital queue which cost me a few months and made it much more serious an issue as what had been biopsied as low grade cancer turned out to be high grade and was growing quickly.  As said you likely have none of the issues I had but you do need to check it out to be sure.  

 

As for the list it is indeed slim but it is changed and kept up to date. 

 

I would advise posting in medical section for recommendations as Sheryl or others may have additional doctors they can recommend if you are unable to use listed doctor.

Edited March 17, 2022 by lopburi3

[Sheryl]

Moved to health forum.

 

Unfortunately the urologist listed in what Lopburi quotes for Chiang Mai has since retired.

 

There was one recent positive review for a urologist now at Sripat:

https://sriphat.med.cmu.ac.th/en/doctor/detail/339

You can read what soemoen had to say about him here, though it appears he is no longer at Bangkok Hospital CM, he is at Sripat

https://aseannow.com/topic/1007906-im-recommending-a-great-urologist-in-chiang-mai-other-than-ajarn-bannakit/

 

If ti turns out to be anything serious  really should come to Bangkok for this IMO.

 

You won't find better than Dr. Charuspong Dissaraan.

[bamboozled]

5 hours ago, lopburi3 said:

No Bangkok Hospital in Bangkok - doctor moved to Bumrungrad Hospital a few months after my operation.  Most likely it will be be nothing but even in the worst case it can most likely be treated so you want to get it checked ASAP.  In my case got bad advise to wait for government hospital queue which cost me a few months and made it much more serious an issue as what had been biopsied as low grade cancer turned out to be high grade and was growing quickly.  As said you likely have none of the issues I had but you do need to check it out to be sure.  

 

As for the list it is indeed slim but it is changed and kept up to date. 

 

I would advise posting in medical section for recommendations as Sheryl or others may have additional doctors they can recommend if you are unable to use listed doctor.

Thanks again, Lop. I was waiting to see a urologist the same day they did the ultrasound only for him to pull a no-show. Now I'm scheduled to meet with one on Saturday.....I don't know the Doc's name, however. At a local hospital here in CM. Yes, no symptoms of anything yet so, of course, I'm hoping it's nothing but will do what needs to be done to make sure that's the case. Glad you got it sorted....? Scary stuff, no doubt. Cheers, Bam

[bamboozled]

5 hours ago, Sheryl said:

Moved to health forum.

 

Unfortunately the urologist listed in what Lopburi quotes for Chiang Mai has since retired.

 

There was one recent positive review for a urologist now at Sripat:

https://sriphat.med.cmu.ac.th/en/doctor/detail/339

You can read what soemoen had to say about him here, though it appears he is no longer at Bangkok Hospital CM, he is at Sripat

https://aseannow.com/topic/1007906-im-recommending-a-great-urologist-in-chiang-mai-other-than-ajarn-bannakit/

 

If ti turns out to be anything serious  really should come to Bangkok for this IMO.

 

You won't find better than Dr. Charuspong Dissaraan.

Thank you, Sheryl, for the help. I did see that thread though it too is pretty dated. I had this ultrasound at Rajavej and at this point I guess I'll meet with their urologist on Sat., if he shows up, that is. I have no idea how difficult a biopsy is...which I'm assuming will be the next step. I would think t's fairly straightforward. If things turn out for the worse, I will certainly consider my options, Bkk included. Thank you, Bam

[SammyJ]

8 hours ago, bamboozled said:

Thanks again, Lop. I was waiting to see a urologist the same day they did the ultrasound only for him to pull a no-show. Now I'm scheduled to meet with one on Saturday.....I don't know the Doc's name, however. At a local hospital here in CM. Yes, no symptoms of anything yet so, of course, I'm hoping it's nothing but will do what needs to be done to make sure that's the case. Glad you got it sorted....? Scary stuff, no doubt. Cheers, Bam

Hello--hope all works out for you--I am facing some similar issues and was just on a search for a

cm urologist--and started a thread here --so search back and look at that as there were some good information shared.

 

I realize, as some advised here, and some advised me, that in bkk there may be more options, but with family here, and other responsibilities here, I likely will need to use a cm doctor.

[lopburi3]

Read up on cystoscopy.  Sounds worse than it normally is but if they see anything needing biopsy they can cut a small sample during procedure.  It is not a really high priced exam and will take about an hour or so including getting ready - you will likely be able to enjoy the video in real time.  

[bamboozled]

1 hour ago, lopburi3 said:

Read up on cystoscopy.  Sounds worse than it normally is but if they see anything needing biopsy they can cut a small sample during procedure.  It is not a really high priced exam and will take about an hour or so including getting ready - you will likely be able to enjoy the video in real time.  

I'm imagining it's similar to a colonoscopy, in some ways., which I've had a few of including taking out a benign growth or two. Hey, if you got both the colonoscopy and cystoscopy at the same time and they met in the middle, clipping and snipping the whole way....what fun!

[lopburi3]

3 minutes ago, bamboozled said:

I'm imagining it's similar to a colonoscopy, in some ways., which I've had a few of including taking out a benign growth or two. Hey, if you got both the colonoscopy and cystoscopy at the same time and they met in the middle, clipping and snipping the whole way....what fun!

This ends at the bladder so much smaller and only a few inches - no meet and greet.  Now if you wish to add an endoscopy you will have full effect.

[elektrified]

19 hours ago, lopburi3 said:

Suspect you did not check the medical section - below is a recommended Doctor in CM.  As one who had serious cancer and bladder removed (5 years ago) believe next step will be the camera insert which is not that painful (mostly full bladder feeling as they fill with water) and may allow them to obtain a sample for biopsy.  It is an outpatient procedure.  In the bad luck event of cancer some can spread rather quickly so time is important.   I used Dr. Charuspong Dissaraan who was working at Bangkok Hospital at the time and highly recommend him.

The following urologists have been favorably  recommended by TV members in the past:

Bangkok
Dr. Viroj Chodchoy at Bumrungrad   - has treated a number of TV members for prostate cancer and other problemshttps://www.bumrungrad.com/doctors/Viroj-Chodchoy  

Dr. Charuspong Dissaraan at Bumrungrad. US trained. https://www.bumrungrad.com/en/doctors/Charuspong-Dissaranan

*Dr. Umaporn Nuanthaisong (female) – Sukhumvit Hospital once a week and also at  Bangkok Hospital and at Chula (try their after hours clinic, 13^th floor) http://www.sukumvithospital.com/en_doctorprofile.php?id=188https://translate.google.com/translate?hl=en&sl=th&u=http:

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=2682&doctor=Dr._UMAPHORN_NUANTHAISONG

//www.chulalongkornhospital.go.th/&prev=search

*Dr. Suntchai Wirotsaengthong – BNH hospital https://www.bnhhospital.com/en/find_doctor/detail/135

* These two have been particulalry recommended for management of chronic prostatitis

 

 

Pattaya

Dr. Pornchai Chayaboon Panyasuppakun, Bangkok Pattaya Hospital  https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=208&depid=28

Dr. Jimmy Kongcharoen Bangkok Pattaya Hospital https://www.bangkokpattayahospital.com/en/doctor-profile?v_id=205&depid=28

 

Chiang Mai

Prof. Bunnakit Lojanaphiwat at CM Ran Hospital, also at Sripat (CMU Hospital) and  he also has his own clinic tel 0818824085http://www.chiangmairam.com/searchdoctor1?major_id=&doctor=103

Lop, Ajarn Bannakit has not practiced for about two years now. He is the Dean of the Faculty of Medicine at CMU and is currently not seeing any patients.

[elektrified]

16 hours ago, Sheryl said:

Moved to health forum.

 

Unfortunately the urologist listed in what Lopburi quotes for Chiang Mai has since retired.

 

There was one recent positive review for a urologist now at Sripat:

https://sriphat.med.cmu.ac.th/en/doctor/detail/339

You can read what soemoen had to say about him here, though it appears he is no longer at Bangkok Hospital CM, he is at Sripat

https://aseannow.com/topic/1007906-im-recommending-a-great-urologist-in-chiang-mai-other-than-ajarn-bannakit/

 

If ti turns out to be anything serious  really should come to Bangkok for this IMO.

 

You won't find better than Dr. Charuspong Dissaraan.

Actually Sheryl, Dr. Bannakit is not retired (he's still young), but he's not seeing any patients. He is the Dean of the Faculty of Medicine at CMU and is currently not seeing any patients.  But not retired.

[bamboozled]

I had seen his name from years before, Bannakit, and was hoping to locate him. I had wondered where he had ended up A shame he's not seeing patients.

[elektrified]

1 hour ago, bamboozled said:

I had seen his name from years before, Bannakit, and was hoping to locate him. I had wondered where he had ended up A shame he's not seeing patients.

In my opinion, he was the only one who could really help in C.M. He was my doctor for many years.

[elektrified]

15 hours ago, bamboozled said:

Thank you, Sheryl, for the help. I did see that thread though it too is pretty dated. I had this ultrasound at Rajavej and at this point I guess I'll meet with their urologist on Sat., if he shows up, that is. I have no idea how difficult a biopsy is...which I'm assuming will be the next step. I would think t's fairly straightforward. If things turn out for the worse, I will certainly consider my options, Bkk included. Thank you, Bam

Having had two biopsies, I recommend you have yours at Chiang Mai Ram. Ram is the only hospital in Chiang Mai that offers general anesthesia during the 20-30 minute biopsy. No other hospital has the required life support equipment in the radiology department and therefore will not give you general anesthesia. At RAM, the O.R. for urology procedures has all the radiology equipment inside. The biopsy will be ultrasound guided. If you don't get the Propofol IV at RAM (anesthesia), they will only give a quick injection of topical anesthetic and when the machine enters your prostate 12-20 times it will be uncomfortable/painful as hell. My friend described it as feeling like he was being bitten by a snake in his prostate over and over!

[bamboozled]

5 hours ago, elektrified said:

Having had two biopsies, I recommend you have yours at Chiang Mai Ram. Ram is the only hospital in Chiang Mai that offers general anesthesia during the 20-30 minute biopsy. No other hospital has the required life support equipment in the radiology department and therefore will not give you general anesthesia. At RAM, the O.R. for urology procedures has all the radiology equipment inside. The biopsy will be ultrasound guided. If you don't get the Propofol IV at RAM (anesthesia), they will only give a quick injection of topical anesthetic and when the machine enters your prostate 12-20 times it will be uncomfortable/painful as hell. My friend described it as feeling like he was being bitten by a snake in his prostate over and over!

Thanks, Elektrified. Does it matter that this is a nodule in my bladder and not something to do with the prostate? I have not read that a biopsy of a bladder nodule is particularly painful. To note, I had general anesthesia at Rajavej midway through a colonoscopy as it was too painful. Does that run counter to your thought that no other hospital offers general anesthesia? Not trying to be combative.... I certainly don't look forward to the feeling of a snake biting me from the inside, don't get me wrong. Tomorrow, I will meet with a urologist at Rajavej and get the lay of the land and then make some decisions about my next move. If I'm assured the next move is pretty straightforward, I'll probably take the path of least resistance and financial obligation and move forward at Rajavej. If things get funky, I'll have to reevaluate. Thank you!

Edited March 18, 2022 by bamboozled

[Sheryl]

1 hour ago, bamboozled said:

Thanks, Elektrified. Does it matter that this is a nodule in my bladder and not something to do with the prostate? I have not read that a biopsy of a bladder nodule is particularly painful. To note, I had general anesthesia at Rajavej midway through a colonoscopy as it was too painful. Does that run counter to your thought that no other hospital offers general anesthesia? Not trying to be combative.... I certainly don't look forward to the feeling of a snake biting me from the inside, don't get me wrong. Tomorrow, I will meet with a urologist at Rajavej and get the lay of the land and then make some decisions about my next move. If I'm assured the next move is pretty straightforward, I'll probably take the path of least resistance and financial obligation and move forward at Rajavej. If things get funky, I'll have to reevaluate. Thank you!

What he told you was for a prostate biopsy which is an altogether different thing from a biopsy of a bladder nodule.

 

Bladder biopsy is as poster Lopburi3 described. Just a catheter (attached to a  camera) in the urethra. They instill a numbing solution first. 

[bamboozled]

Thank you, Sheryl. I'll report back for the masses what I find out today.

[Lacessit]

I have regular checks for bladder cancer with Dr. Wittawat Rawiyotai at Bangkok Hospital in Chiang Mai. Speaks good English, answers all my questions. Does cystoscopies under local anesthesia, 18,000 baht.

The last cystocopy I had was in November. He found an inflamed nodule which he biopsied, about 5000 baht extra. No issues with the biopsy.

Apologies if that information is too late to be useful, I've only just seen the thread.

[bamboozled]

5 hours ago, Lacessit said:

I have regular checks for bladder cancer with Dr. Wittawat Rawiyotai at Bangkok Hospital in Chiang Mai. Speaks good English, answers all my questions. Does cystoscopies under local anesthesia, 18,000 baht.

The last cystocopy I had was in November. He found an inflamed nodule which he biopsied, about 5000 baht extra. No issues with the biopsy.

Apologies if that information is too late to be useful, I've only just seen the thread.

It's very useful, thanks. I just got finished speaking with the urologist at Rajavej. He recommended taking out the nodule at a cost of 100k (estimated) and a 2 - 4 day hospital stay. I felt rushed and that the various scenarios were not discussed much. I asked about just doing the scope/biopsy but he seemed to suggest it was better just to take it out and not worry about it anymore. That sounds nice in a way but I have no knowledge yet about how dangerous a  non-cancerous nodule is. I didn't realize taking one out was such a big procedure....this would be under general anesthesia. So, Lacessit, were you ever diagnosed with cancer and what is your take on having a nodule in the bladder? I guess you/your doctor are not of the idea that a nodule necessitates removal. I did not really have time enough to discuss much in depth with the Dr. today as he seemed anxious to see the next patient. That didn't seem so great and so I'm still in the research phase. Thanks!

Edited March 19, 2022 by bamboozled

[Lacessit]

10 minutes ago, bamboozled said:

It's very useful, thanks. I just got finished speaking with the urologist at Rajavej. He recommended taking out the nodule at a cost of 100k (estimated) and a 2 - 4 day hospital stay. I felt rushed and that the various scenarios were not discussed much. I asked about just doing the scope/biopsy but he seemed to suggest it was better just to take it out and not worry about it anymore. That sounds nice in a way but I have no knowledge yet about how dangerous a  non-cancerous nodule is. I didn't realize taking one out was such a big procedure....this would be under general anesthesia. So, Lacessit, were you ever diagnosed with cancer and what is your take on having a nodule in the bladder? I guess you/your doctor are not of the idea that a nodule necessitates removal. I did not really have time enough to discuss much in depth with the Dr. today as he seemed anxious to see the next patient. That didn't seem so great and so I'm still in the research phase. Thanks!

I have had Stage 1 bladder cancer since 2006. All of my surgeries in Australia to remove it were done under general anesthesia.

I have yet to have a recurrence in Thailand, touch wood.

At Bangkok Hospital in Chiang Mai, I was presented with the option of having my cystoscopy under local anesthetic ( 18,000 baht ) or a general ( from memory, 53,000 baht ). I gritted my teeth, and opted for the local. While it is no fun, I can cope with the discomfort. Dr. Wittawat explained what he was doing every step of the way.

When he did the biopsy, there was a bit of pain as the nibbler took a chunk out of my bladder wall. Some blood afterwards, which cleared in 24 hours.

 

It all depends on individual pain tolerance. I'd suggest doing the local route first, with the biopsy. If the pathology comes back positive for cancer, then go for the general anaesthetic for removal.

In my case, with the small inflammation area, the pathology took a week to come back.

 

I'd say 100,000 baht is probably a fair price for complete removal. The stay in hospital would be to ensure you stopped passing blood, which is inevitable with such surgery.

[bamboozled]

Thanks again, Lacesit. Touch wood for me, too, that it's not cancer. I've read some info on the net saying that bladder nodules are more often cancerous than not. But only some sites say that. I do not have a clear idea of what the real story is. I guess that's what I'd like to know, and if it isn't cancerous, is it safe to go on my merry way leaving it in there. If it's something that sooner or later is going to have to come out, cancerous or not, I guess I would think to get it over with in one fell swoop. I wish the Dr. had taken the time to answer my questions. I think I will look up your guy, or the Dr. recommended at Siriphat Hospital, and get a second opinion. I paid somewhere between 30k and 40k for a colonoscopy with general anesthesia, and removal of a polyp or two, maybe 5 years ago (if my memory serves me) so I was surprised this one is 100k. Perhaps it's apples and oranges and 5 years later.

[Lacessit]

11 minutes ago, bamboozled said:

Thanks again, Lacesit. Touch wood for me, too, that it's not cancer. I've read some info on the net saying that bladder nodules are more often cancerous than not. But only some sites say that. I do not have a clear idea of what the real story is. I guess that's what I'd like to know, and if it isn't cancerous, is it safe to go on my merry way leaving it in there. If it's something that sooner or later is going to have to come out, cancerous or not, I guess I would think to get it over with in one fell swoop. I wish the Dr. had taken the time to answer my questions. I think I will look up your guy, or the Dr. recommended at Siriphat Hospital, and get a second opinion. I paid somewhere between 30k and 40k for a colonoscopy with general anesthesia, and removal of a polyp or two, maybe 5 years ago (if my memory serves me) so I was surprised this one is 100k. Perhaps it's apples and oranges and 5 years later.

I'm surprised by the difference in local and general anesthesia here too. In Australia, general anesthesia is about one-third of the cost of the cystoscopy or colonoscopy itself. Here, it triples the cost of the procedure. Perhaps that is supply and demand, too few anesthetists.

I would suggest the cost component of a hospital stay in Bangkok Hospital CM is more than that of Rajavej. Never had to stay in either.

Apart from the cost factor, I prefer a local because I am good to go after an hour's rest. With a general, recovery is longer and I can't drive a vehicle for 24 hours. Not without looking like many Thai drivers, anyway.

[Sheryl]

2 hours ago, bamboozled said:

It's very useful, thanks. I just got finished speaking with the urologist at Rajavej. He recommended taking out the nodule at a cost of 100k (estimated) and a 2 - 4 day hospital stay. I felt rushed and that the various scenarios were not discussed much. I asked about just doing the scope/biopsy but he seemed to suggest it was better just to take it out and not worry about it anymore. That sounds nice in a way but I have no knowledge yet about how dangerous a  non-cancerous nodule is. I didn't realize taking one out was such a big procedure....this would be under general anesthesia.

 

This is not making any sense to me.If the nodule is benign  there is no need to remove it. If it cancerous or pre-cancerous then in addition to removing it you would need further follow up.

 

And you should not be seeing a doctor who rushes you like that.

 

I suggest you see one of the 2 doctors so far recommended in Chaing Mai for cystoscopy and biopsy under local anesthetic.  Sripat will likely cost less than Bangkok Hospital but may take longer to book.

 

If the biopsy comes back malignant then IMO you should at that point definitely come to Bangkok and see  Dr. Charuspong Dissaraan.

 

 

 

[bamboozled]

1 hour ago, Sheryl said:

 

This is not making any sense to me.If the nodule is benign  there is no need to remove it. If it cancerous or pre-cancerous then in addition to removing it you would need further follow up.

 

And you should not be seeing a doctor who rushes you like that.

 

I suggest you see one of the 2 doctors so far recommended in Chaing Mai for cystoscopy and biopsy under local anesthetic.  Sripat will likely cost less than Bangkok Hospital but may take longer to book.

 

If the biopsy comes back malignant then IMO you should at that point definitely come to Bangkok and see  Dr. Charuspong Dissaraan.

 

 

 

Thank you, Sheryl. I didn't like the rushed part either....and feeling stupid asking questions like I'm wasting the Dr.'s time. As mentioned, I didn't know anything about bladder nodules....just what I'm learning now. I will def see one of the above mentioned doctors in this thread and report back..

 

[elektrified]

19 hours ago, Sheryl said:

What he told you was for a prostate biopsy which is an altogether different thing from a biopsy of a bladder nodule.

 

Bladder biopsy is as poster Lopburi3 described. Just a catheter (attached to a  camera) in the urethra. They instill a numbing solution first. 

Sorry, my misunderstanding. I thought prostate was mentioned.

[bamboozled]

10 minutes ago, elektrified said:

Sorry, my misunderstanding. I thought prostate was mentioned.

No worries! I'm sure to have that on down the line, too!

[lopburi3]

37 minutes ago, bamboozled said:

No worries! I'm sure to have that on down the line, too!

Having bladder removed took that also - so one less thing in the old age cycle to worry about.

 

In any event suspect you have found early so likely even if cancer your prognosis should be good.  My check was due to blood in urine (which seemed to only occur after evening walks, which can be nothing, so waited longer than I should have). 

[bamboozled]

22 minutes ago, lopburi3 said:

Having bladder removed took that also - so one less thing in the old age cycle to worry about.

 

In any event suspect you have found early so likely even if cancer your prognosis should be good.  My check was due to blood in urine (which seemed to only occur after evening walks, which can be nothing, so waited longer than I should have). 

Oh shoot, that stinks. I'm glad to hear you got through that. I guess I should use this as a public service announcement to prod folks to get a regular check-up. I've kind of been doing that every couple years and look what turned up, nice and early...the nodule. The check-up is under 5k at Rajavej for men for their premium service. A little bit more for women depending on a couple add-ons. I have no idea how to compare it to another hospital but I would think an ultrasound is an ultrasound and a blood test for X, Y, Z is pretty standard as is an EKG, etc.... Sure, depends who's reading the chart, I guess, but I've been happy enough with it. You can add on different tests, too, as you wish.