Good Value Health Check (or Lab) in Bangkok

[2009]

12 minutes ago, Sheryl said:

A lot there that a healthy perdkn in their 30's does  not need. Including a few things not suitable for  routine screening at any age.

 

 

This is the one  they have for people in their 30s.

 

What do you make of it?

Edited September 13, 2022 by 2009

[Lorry]

3 hours ago, Sheryl said:

A lot there that a healthy perdkn in their 30's does  not need. Including a few things not suitable for  routine screening at any age.

 

 

Exactly. 

2 unnecessary radiation

3+4 maybe fun, but useless

5+6 can't hurt

7 useless in a healthy person

8,9 good idea

10 if you really want to check the liver,  check yGT, not the stuff they check

11 one of both is good enough,  preferably creatinine

12 good idea

13 can't hurt

14 good idea

15 hotly debated as a screening test

16,17 not suitable as screening test

18 useless in a healthy person, not suitable as a screening test

[internationalism]

4 hours ago, 2009 said:

So, at the Red Cross, it's just the blood tests for 600? Is that correct?

 

What blood tests are covered?

 

 

not only blood, that's why several different building and full day of waiting.

People go there for visa health check up.

Go instead to St Louise, mentioned was only slightly more expensive than the RC, but only in 1h.

I did my at the governmental for 1800b VIP clinic, about 2h.

Plus at another governmental 3 cancer markers, ekg, second and third FOB for 1600b and ultrasound abdomen 2700b.

That leads to colonoscopy+gastroscopy under full anastesia for 18.5k, booked for december. Had to do 6 additional blood checks and will have to do chest xray and ATK

 

[2009]

7 hours ago, Lorry said:

Exactly. 

2 unnecessary radiation

3+4 maybe fun, but useless

5+6 can't hurt

7 useless in a healthy person

8,9 good idea

10 if you really want to check the liver,  check yGT, not the stuff they check

11 one of both is good enough,  preferably creatinine

12 good idea

13 can't hurt

14 good idea

15 hotly debated as a screening test

16,17 not suitable as screening test

18 useless in a healthy person, not suitable as a screening test

Could you elaborate at little please?

 

X-rays and ultrasounds can definitely show things that are there, even in asymptomatic people.

 

I know someone who had a 6cm cancerous tumor in the lung without symptoms found while doing a routine chest x-ray for a working visa.

Edited September 14, 2022 by 2009

[Lorry]

2 hours ago, 2009 said:

Could you elaborate at little please?

 

X-rays and ultrasounds can definitely show things that are there, even in asymptomatic people.

 

I know someone who had a 6cm cancerous tumor in the lung without symptoms found while doing a routine chest x-ray for a working visa.

As Sheryl explained before: if you screen healthy people,  you will find many false positives and you will bring them into the diagnostic machinery,  which may be quite invasive and harmful. 

PSA is an example: not testing will miss some cancers (some of them will never spread),  testing will result in a lot of unnecessary harmful biopsies. So in case of PSA, it's a difficult decision. 

 

X-rays are harmful per se, so they should rarely be used as a screening tool. To x-ray millions of healthy people (in order to find one case of cancer,  your acquaintance) you may cause two radiation-related cancers. It's a question of statistics. 

 

Screening is useful if its harmless and there is a reasonably high chance of finding something. Blood in stool ifs the best example.

FBS and HbA1c in elderly farang in Thailand,  too, not if you are 41. Same for lipid profile.

 

Ultrasound of healthy people is harmless and fun, but the results are too unspecific to be useful (same for the tumor markers and CBC).

 

These packages are money-making exercises feeding on the naive belief in technology in medicine. 

[scubascuba3]

8 minutes ago, Lorry said:

As FBS and HbA1c in elderly farang in Thailand,  too, not if you are 41.

Useful if you are a bloater and need to see it in black and white to change diet

[2009]

14 minutes ago, Lorry said:

As Sheryl explained before: if you screen healthy people,  you will find many false positives and you will bring them into the diagnostic machinery,  which may be quite invasive and harmful. 

PSA is an example: not testing will miss some cancers (some of them will never spread),  testing will result in a lot of unnecessary harmful biopsies. So in case of PSA, it's a difficult decision. 

 

X-rays are harmful per se, so they should rarely be used as a screening tool. To x-ray millions of healthy people (in order to find one case of cancer,  your acquaintance) you may cause two radiation-related cancers. It's a question of statistics. 

 

Screening is useful if its harmless and there is a reasonably high chance of finding something. Blood in stool ifs the best example.

FBS and HbA1c in elderly farang in Thailand,  too, not if you are 41. Same for lipid profile.

 

Ultrasound of healthy people is harmless and fun, but the results are too unspecific to be useful (same for the tumor markers and CBC).

 

These packages are money-making exercises feeding on the naive belief in technology in medicine. 

Surely getting a couple of X-rays in your lifetime (I wouldn't be doing it every year) isn't likely to result in cancer. Especially, compared with all the carcinogens in our life nowadays.

 

And they ain't gonna biopsy anything if they don't find something to biopsy. I don't really get your point on this one.

 

I can actually think of almost 10 people I personally know, or friends of family, who were diagnosed with, or died from, something in the West that could have been spotted years before if had they been screened. The GP was using statistics, of course, while managing his budget and didn't want to send them up to the hospital.

 

I think there is a place for these big comprehensive screenings once a decade (less in-depth testing more regularly perhaps) after you become middle-aged and the benefits likely outweigh the risks.

Edited September 14, 2022 by 2009

[Lorry]

1 hour ago, 2009 said:

Surely getting a couple of X-rays in your lifetime (I wouldn't be doing it every year) isn't likely to result in cancer. Especially, compared with all the carcinogens in our life nowadays.

 

And they ain't gonna biopsy anything if they don't find something to biopsy. I don't really get your point on this one.

 

I can actually think of almost 10 people I personally know, or friends of family, who were diagnosed with, or died from, something in the West that could have been spotted years before if had they been screened. The GP was using statistics, of course, while managing his budget and didn't want to send them up to the hospital.

 

I think there is a place for these big comprehensive screenings once a decade (less in-depth testing more regularly perhaps) after you become middle-aged and the benefits likely outweigh the risks.

First, you focus too much on cost saving policies of the NHS. I have heard terrible stories about the NHS, but my point of reference is Western Europe. 

Second, you are  not alone in having difficulties grasping the meaning of statistics for personal decisions. 

If you profit from an X-ray statistically by .01%, and statistically it will harm you by .02%, you shouldn't do it. It's a futile money-making exercise. 

[internationalism]

I think one chest x-ray per year is  recommended. That's always included in yearly check ups.

During pandemic people do have a lot of chest x-rays, for any suspected lung infection, that includes covid (yet before pcr tests result come back from laboratory).

I had xray after testing positive and compulsory hospitalisation with mild covid.

Another time over one month after covid, while some coughing.  

On my yearly check up was included x-ray, in restrospect not sure if I really needed one. Unless in those lung/covid fast x-rays they don't concentrate on anything else, like possible cancer (they don't have time and inclination to fully investigate), just look for infection.

I have also had 4 x-ray for pneumonia ans another one 2 weeks after hospital discharge.

And another one coming before colonoscopy. They wanted me to do it immediately on the day for booking colonoscopy appointment for December. I have asked them why is it needed, their answer was "because the system needs it". I was able to postpone that x-ray for just before December. That would be my 9th xray in 11 months. I have tried to explain nurses my situation, but they need to tick this on computer 

 

Edited September 14, 2022 by internationalism

[2009]

31 minutes ago, Lorry said:

First, you focus too much on cost saving policies of the NHS. I have heard terrible stories about the NHS, but my point of reference is Western Europe. 

Second, you are  not alone in having difficulties grasping the meaning of statistics for personal decisions. 

If you profit from an X-ray statistically by .01%, and statistically it will harm you by .02%, you shouldn't do it. It's a futile money-making exercise. 

From an objective point of view, you may be right. The masses don't care about one individual

 

 

But from a subjective point of view (e.g. someone who wants a mid-life screening to make sure things are in order) it makes sense. And if it catches a disease early then it's money well spent.

 

Something might show up in the screening (hopefully not) and that would be important for the individual - not the overall population at large. Who cares about others, really anyway?

 

I suppose you don't recommend routine STD for sexually active people?

 

And before you answer, I'd like to inform you that the odds of a sexually active heterosexual having HIV, for example, are far far far far less than the odds of them having: undiagosed diabetes, a liver problem, a kidney problem, a heart attack about to happen, a stroke about to happen, or even some kind of cancer diagnosis over the next decade.

 

These things are common. They are the biggest killers in humans.

 

 

 

 

Edited September 14, 2022 by 2009

[Sheryl]

22 hours ago, 2009 said:

This is the one  they have for people in their 30s.

 

What do you make of it?

It is Ok though the  abdominal ultrasound is unnecessary.

[2009]

18 minutes ago, Sheryl said:

It is Ok though the  abdominal ultrasound is unnecessary.

Can I infer that you mean the other tests would cover that (i.e. the liver and kidney function tests would detect problems, therefore the ultrasound is not needed)?

 

Is there any scenario where you could have something up with your liver (e.g. cancer tumor) but the liver function test comes back within normal range?

[Sheryl]

1 minute ago, 2009 said:

Can I infer that you mean the other tests would cover that (i.e. the liver and kidney function tests would detect problems, therefore the ultrasound is not needed)?

 

Is there any scenario where you could have something up with your liver (e.g. cancer tumor) but the liver function test comes back within normal range?

Certainly it is possible that an ultrasound might show something that did not show up in blood work.

 

But it is far more likely that an ultrasound would  lead to unnecessary further tests and procedures due to findings of ultimately no significance.

 

Abdominal ultrasounds are not recommended for routine health screening  by any public health authority, anywhere. (People with known underlying conditions/risk factors are a different matter).

 

There is no check up you can get that will 100% identify all possible illnesses, simply not possible. Only certain conditions lend themselves to detection through routine screening. The point of a check up is to screen for those conditions, not all possible conditions.

 

[internationalism]

from my very limited experience in thailand all doctors downplay symptoms and are poor communicators (language barier might be part of it).

Even at private hospital I have to insist on proper tests, as if they don't care or treat patient as hypochondriac.

The only time I have abdomen palpation was this week and it lasted 5 seconds glide over skin.

On base of that examination she wanted to prescribe me antacid medication.

No knowing anything about me she suggested "lifestyle changes".

Sharp abdomen pain from time to time, in her opinion, was normal. She explained that "bones press on veins" - which for me sounds bullocks.

She dismissed childhood hep B which is chronic and said liver pain was normal state.

That was a visit to a gastro specialist, also claiming to conduct some medical research.

From my doctor's visit in europe I do remember different setting, 

They would do proper physical examination, do record on file all info, refer for further check ups.

 

[Lorry]

11 hours ago, internationalism said:

I think one chest x-ray per year is  recommended

By whom?

 

11 hours ago, internationalism said:

I had xray after testing positive

Especially the private hospitals did this with farang patients.

In other countries,  the doctor could be sued for malpractice if the only reason for the x-ray is a positive covid test. 

An x-ray machine is not a toy.

[internationalism]

19 hours ago, Lorry said:

By whom?

 

Especially the private hospitals did this with farang patients.

In other countries,  the doctor could be sued for malpractice if the only reason for the x-ray is a positive covid test. 

An x-ray machine is not a toy.

That's why I stated "I think".

All yearly health check ups include x-ray. They don't ask or warn how often x-ray can be done.

Yes, that was piyavate hospital, which conducted x-ray for mild omicron. But just 3 weeks before I had pneumonia with 4 nights hospitalisation, so maybe it was sensible to have it (even if  my 2 weeks post hospital check  up was clean).

I can't sue them, as my insurance declined to pay full invoice 

Edited September 15, 2022 by internationalism

[mstevens]

On 9/15/2022 at 12:37 AM, 2009 said:

Can I infer that you mean the other tests would cover that (i.e. the liver and kidney function tests would detect problems, therefore the ultrasound is not needed)?

 

Is there any scenario where you could have something up with your liver (e.g. cancer tumor) but the liver function test comes back within normal range?

Indeed, there are many possible issues with the liver where liver enzyme levels come back as normal but in fact there is an issue. I can't remember all the different liver tests but ALT, bilirubin and one other I can't remember are the 3 typically checked in a standard liver test. If you have a fatty liver, for example, nothing might show up. As I understand it, your liver is still working, it just happens to working a whole lot harder because it's fatty. In many cases, you need an ultrasound to test for such things.

 

So to answer your question, yes, absolutely, there are scenarios where there could be an issue but nothing shows up in the standard test.