Which of these checkup tests at Chula hospital needed?

[david_je]

Chula checkup tests.pdfI am American male, 65, in good health, with healthy lifestyle. I will do routine checkup at Chulalongkorn Hosp., the basic package on upper left but wondering which of the additional tests on the right column I may need.

Also specifically wondering:

At previous checkup, 4 years ago, my anti-HBs was 27.1, which doc said indicated I was immune to Hep B. That means I definitely do not need the HBV test on the list, correct?

She also said I should get Free T4 and TSH tested at next checkup (it was slightly elevated in last test). Those fall under Thyroid on the list, correct?

I recall Sheryl recommending digital rectal exam and stress test, but these do not appear to be listed here. If I request during checkup, perhaps they won't or cannot do? How to handle this?

Thank you.

[Sheryl]

You indeed do not need the HBV since you already know you have antibodies (and assuming your HB antigen at at check up was negative).

 

Thyroid on the list is probably only TSH, if you also need Free T4 may need to ask about that.

 

If you have never been tested for HCV then good idea to have it done once. If you have bene, then no need.

 

Definitely get the LDL-Cholesterol  direct as what you will get in the basic package is only an indirect (estimated) rate.

 

Also get the HB1Ac (in fact with that, there is no need for the glucose in the basic package)

 

Get the PSA - make sure no sexual activity or bike/moto riding for 48 hours before the blood draw as these can artificially raise it

 

Stool for occult blood a good idea. If you have nto had a colonoscopy in past 10 years, then you should but that is another matter and would nto be in the check up dept.

 

I cannot read the 3rd from the bottom item on the "extra" menu. If it is AB index (ankle/brachial index) then yes get it.

 

anti-HIV if you have had any possible exposure since last HIV test (if applicable)

 

Yes, a DRE (rectal exam of the prostate) is indicated at your age and a stress test would be an excellent idea. You can ask about these but at Chula they might say you have to consult urologist and cardiologist to order it, respectively. No harm in asking though. I note that no hands on physical exam of any type is listed here, seems to be only labs/xray/EKG.

[david_je]

On 9/20/2022 at 4:27 PM, Sheryl said:

You indeed do not need the HBV since you already know you have antibodies (and assuming your HB antigen at at check up was negative).

 

Thyroid on the list is probably only TSH, if you also need Free T4 may need to ask about that.

 

If you have never been tested for HCV then good idea to have it done once. If you have bene, then no need.

 

Definitely get the LDL-Cholesterol  direct as what you will get in the basic package is only an indirect (estimated) rate.

 

Also get the HB1Ac (in fact with that, there is no need for the glucose in the basic package)

 

Get the PSA - make sure no sexual activity or bike/moto riding for 48 hours before the blood draw as these can artificially raise it

 

Stool for occult blood a good idea. If you have nto had a colonoscopy in past 10 years, then you should but that is another matter and would nto be in the check up dept.

 

I cannot read the 3rd from the bottom item on the "extra" menu. If it is AB index (ankle/brachial index) then yes get it.

 

anti-HIV if you have had any possible exposure since last HIV test (if applicable)

 

Yes, a DRE (rectal exam of the prostate) is indicated at your age and a stress test would be an excellent idea. You can ask about these but at Chula they might say you have to consult urologist and cardiologist to order it, respectively. No harm in asking though. I note that no hands on physical exam of any type is listed here, seems to be only labs/xray/EKG.

Thank you for taking time for that very helpful reply.

Physical exam is listed in Thai with basic package, but from experience at Chula, it is only cursory look aside from measuring blood pressure, weight, etc. -- should I be concerned about that?

The one 3rd from bottom in Extras is blood group.

They said, yes, digital rectal and stress need to be ordered separately at specialists.

Do I need AB Index also? Anything else missing that I need ordered separately from checkup package?

And should I get AFP -- is risk higher if father died of liver cancer and I have lived in SEAsia for 30 years?

 

[Sheryl]

31 minutes ago, david_je said:

Thank you for taking time for that very helpful reply.

Physical exam is listed in Thai with basic package, but from experience at Chula, it is only cursory look aside from measuring blood pressure, weight, etc. -- should I be concerned about that?

The one 3rd from bottom in Extras is blood group.

They said, yes, digital rectal and stress need to be ordered separately at specialists.

Do I need AB Index also? Anything else missing that I need ordered separately from checkup package?

And should I get AFP -- is risk higher if father died of liver cancer and I have lived in SEAsia for 30 years?

 

If AB index were readily available it would be worth getting but, in the absence of any symptoms of peripheral arterial disease (such as pain on walking) I don't think it is worth going to extra trouble to get.

 

Having lived in SE Asia is nto a risk for liver disease per se if you do not have chronic hepatitis B or Hep C, have never had liver fluke and do not drink excessively. The comparatively high incidence of primary liver cancer in SE Asia is due to (1) higher than average prevalence of chronic hepatitis B, usually contacted at birth and (2) high incidence of liver fluke related to eating of raw fish. Foreign-born people who do not eat raw fish and do nto have chronic Hep B or Hep C, are at no more risk than if they lived in their home countries i.e. very low risk indeed. 

 

Most liver cancer in the West is due to metsatasis from other types of cancers (many cancers metastasize to the liver). Are you sure your father died of primary liver cancer and not metastatic liver cancer? If the latter, metastasis from where?