D-Dimer Test Positive

[Neeranam]

Just back from hospital where the doc said I have a positive D-Dimer test. 

This has to do with embolisms he said. The doctor was in a rush and I really was disgusted with the service but that's off topic. 

The result was 0.52 and he said it was only slightly positive and could be to do with my age, 56. 

He said it was entirely up to me to take this further and get another test but he wasn't sure what he would recommend, but please sign a form saying I was not going to take the test. 

So, I'm confused, am I doing the right thing?

[lopburi3]

Hard to know much but was there a reason they did that test (an injury could account for it from my reading)?  You might want to be this overview which seems to be easy to understand.

https://my.clevelandclinic.org/health/diagnostics/22045-d-dimer-test

[Neeranam]

38 minutes ago, lopburi3 said:

Hard to know much but was there a reason they did that test (an injury could account for it from my reading)?  You might want to be this overview which seems to be easy to understand.

https://my.clevelandclinic.org/health/diagnostics/22045-d-dimer-test

Thanks, it's included in the Long Covid package at BKk Hospital. 

[Lorry]

4 hours ago, Neeranam said:

result was 0.52

Which unit? If it's mg/l that's hardly "positive" at all.

Anyway,  isolated elevated d-dimeres don't mean anything.  It depends on the context: clinical symptoms,  other lab values are much more important.  You really have to discuss the whole picture with the doctor. 

[Sheryl]

.50 is the upper limit of normal so 0.52 isn't much of an elevation.  I assume that what was recommended was  a pulmonary CT with contrast. That is a standard recommendation when D-Dimer is elevated and is meant mainly to see if you have thromboembolic complucations. It will also give a clear picture of the condition of your lung tissue.

 

If your oxygenation levels were at all reduced then I would say this is essential.  If not and given the low level of increase it is a harder call. You really need to discuss this (and the other findings)  with a good pulmonoligist. 

 

The quality of review of findings with check up packages are often poor/cursory at best.  In addition the tests included may not be what you need. These things are often  put together by hospital marketing departments and, especially the disease specific packages, do not always   make the best medical sense. 

 

In addition the implicit self-diagnosis which determined what package to get  can be wrong.

As I have mentioned before your shortness of breath is as likely to be due to a cardiac issue as to a   pulmonary one.

 

Where in Thailand are you located?

[Neeranam]

8 hours ago, Sheryl said:

.50 is the upper limit of normal so 0.52 isn't much of an elevation.  I assume that what was recommended was  a pulmonary CT with contrast. That is a standard recommendation when D-Dimer is elevated and is meant mainly to see if you have thromboembolic complucations. It will also give a clear picture of the condition of your lung tissue.

 

If your oxygenation levels were at all reduced then I would say this is essential.  If not and given the low level of increase it is a harder call. You really need to discuss this (and the other findings)  with a good pulmonoligist. 

 

The quality of review of findings with check up packages are often poor/cursory at best.  In addition the tests included may not be what you need. These things are often  put together by hospital marketing departments and, especially the disease specific packages, do not always   make the best medical sense. 

 

In addition the implicit self-diagnosis which determined what package to get  can be wrong.

As I have mentioned before your shortness of breath is as likely to be due to a cardiac issue as to a   pulmonary one.

 

Where in Thailand are you located?

I'm in Hua Hin. 

Im disappointed with the hospital I went to. The first day,  I was told the doctor had to go to emergency,  could I wait 1.5 hours. Then told to come later that day. I couldn't so made an appointment the next day to see him. When going at that time, was told the doctor had an emergency,  could I wait 1.5 hours. I made a fuss and told to wait. 2 min later was ushered to room,  where the doc was sitting. He was extremely abrupt,  seemed more concerned as how I could be a Thai citizen,  asking me inappropriate questions about my birth. When I asked about the ECG results if any abnormalities he said,  sorry you have to make an appointment with the heart doc. Very disorganised and when finished I saw him leaving with two young ladies talking about eating, which I assume was the emergency. 

I got two inhalers,  after the result of the lung test. One ventolin and the other a dry one.my test improved 12% after taking a puff of ventolin. 

The doc said take 2 times a day,  never mentioned there were 2.

The pharmacist said take one 4 fines a day and the dry one two. 

Made can appointment fir today,  heart specialist  but going to cancel,  terrible service,  and expensive,  edp as I could use SS. 

Thanks Sheryl,  if you can recommend anyone that would be great. 

One booked us Ekasit intaranonwilai. 

 

 

Edited August 25, 2022 by Neeranam

[Neeranam]

7 hours ago, Neeranam said:

I'm in Hua Hin. 

Im disappointed with the hospital I went to. The first day,  I was told the doctor had to go to emergency,  could I wait 1.5 hours. Then told to come later that day. I couldn't so made an appointment the next day to see him. When going at that time, was told the doctor had an emergency,  could I wait 1.5 hours. I made a fuss and told to wait. 2 min later was ushered to room,  where the doc was sitting. He was extremely abrupt,  seemed more concerned as how I could be a Thai citizen,  asking me inappropriate questions about my birth. When I asked about the ECG results if any abnormalities he said,  sorry you have to make an appointment with the heart doc. Very disorganised and when finished I saw him leaving with two young ladies talking about eating, which I assume was the emergency. 

I got two inhalers,  after the result of the lung test. One ventolin and the other a dry one.my test improved 12% after taking a puff of ventolin. 

The doc said take 2 times a day,  never mentioned there were 2.

The pharmacist said take one 4 fines a day and the dry one two. 

Made can appointment fir today,  heart specialist  but going to cancel,  terrible service,  and expensive,  edp as I could use SS. 

Thanks Sheryl,  if you can recommend anyone that would be great. 

One booked us Ekasit intaranonwilai. 

 

 

Well what a difference today,  an excellent, professional, polite doctor that didn't rush me away. Highly recommended. 

Nothing wrong with my heart,  ????

[CanNot]

I also had increased D-Dimer. They did a lung and leg CT to check for blood clot. As they found nothing they said its most likely an ongoing inflammation, which in the end was true. 

However I was told that the D-Dimer test is not very specific and when the CT is normal there is not a lot they will do.