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Posted

Seems about right...   & go to a different doctor for a follow up in 90 days... 

 

I've had similar issues with some doctors where their logic conflicts with common sense. 

 

i.e. I had kidney pain, suspected a stone...  They took an X-ray and CT scan...  It was there - small enough to pass.

I was given medical to enlarge the eurethra and enjoyed pi$$ing like a race-horse for two weeks.

After two weeks the Dr wanted to do another CT scan.

 

I pointed out that an abdominal CT scan exposes me to about 10mSv (which is about the equivalent of 8 years exposure to natural background radiation / as comparison a regular X-ray is about 0.1mSv - equivalent to about 10 days / estimates vary of course).

 

I asked for what gain is a second CT scan required, what decisions would be made from any of the imagery ?... 

Dr couldn't answer other than to say we'd know if I passed the stone or not.

 

I asked does he really want to expose me to a further 8 years or radiation for something on which no decisions will be made ?

 

I pointed out that if I have kidney pain again, then I'll know it didn't pass...  If it did, then there will be no further pain, either way nothing is going to be done anyway, unless I have major pain.

 

Dr agreed that no further CT scan was required. 

 

(a follow up routine medical a year later with abdominal ultra-sound and and x-ray didn't find any further kidney stone).

 

 

 

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Posted

I'm thinking we'll just handle this ourselves.  I'm currently on 20mg daily, have been for almost 20 years, and have been maintaining correct levels.  Test every 3-4 months and adjust dosage accordingly.

 

She can continue 20mg as well, and we'll stop by a clinic across from Tesco every 6-8 weeks for blood tests to confirm.

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Posted

I think one of the problems is that medicine has become far too complicated for a doctor to handle by themselves so I suspect (but don't know) the have like a script when they look at their computer screen during a consultation that guides them through what to do for most situations BUt that script does not deal with anything but the basic process.

For example I have a thing called "a long QT" as shown by my EKG. This long QT can be exacerbated by some antibiotics and can cause sudden death.

In my hospital profile I have advised them that one antibiotic I should not take are a class called Flouroquiinlones bcause of this issue.

Notwithstanding I have been prescribed them several times for various treatment - I supect because that's what the "script" says to prescribe.

Posted

As mentioned above you can manage this yourself by going to a lab and get tests, I can't see LDL and total cholesterol staying down unless she changes diet, that won't happen so needs to maintain meds and adjust if applicable 

Posted
10 hours ago, richard_smith237 said:

 

I pointed out that an abdominal CT scan exposes me to about 10mSv (which is about the equivalent of 8 years exposure to natural background radiation / as comparison a regular X-ray is about 0.1mSv - equivalent to about 10 days / estimates vary of course).

 

 

Thanks for highlighting that point - 'equivalent to 8 years versus 10 days - of background radiation'.

 

Over about 40 years, I have about 12 X-ray investigations (with say 5 shots average) of my 'torso', mostly hips, abdomen and spine; with just one CT scan (blood in urine issue - employer requirement).

 

Now, I feel a bit better about my exposure to all that unwanted radiation over many years!

 

Made up my mind on this one - no more CT scans.

Posted
14 hours ago, richard_smith237 said:

Seems about right...   & go to a different doctor for a follow up in 90 days... 

 

I've had similar issues with some doctors where their logic conflicts with common sense. 

 

i.e. I had kidney pain, suspected a stone...  They took an X-ray and CT scan...  It was there - small enough to pass.

I was given medical to enlarge the eurethra and enjoyed pi$$ing like a race-horse for two weeks.

After two weeks the Dr wanted to do another CT scan.

 

I pointed out that an abdominal CT scan exposes me to about 10mSv (which is about the equivalent of 8 years exposure to natural background radiation / as comparison a regular X-ray is about 0.1mSv - equivalent to about 10 days / estimates vary of course).

 

I asked for what gain is a second CT scan required, what decisions would be made from any of the imagery ?... 

Dr couldn't answer other than to say we'd know if I passed the stone or not.

 

I asked does he really want to expose me to a further 8 years or radiation for something on which no decisions will be made ?

 

I pointed out that if I have kidney pain again, then I'll know it didn't pass...  If it did, then there will be no further pain, either way nothing is going to be done anyway, unless I have major pain.

 

Dr agreed that no further CT scan was required. 

 

(a follow up routine medical a year later with abdominal ultra-sound and and x-ray didn't find any further kidney stone).

 

 

 

 

I had a provisional diagnosis of a renal stone (slightly elevated RBC in urinalysis). When I asked the renal specialist for the ultrasound at the local hospital, he refused and said the CT scan was better, no argument. Went ahead and booked it, around 13000 baht, day after tomorrow.

 

The next day, visited a private hospital, explained the provisional diagnosis and their specialist recommended an ultrasound, carried out an hour later. This confirmed one, small renal calculi. Being asymptomatic, I was advised to drink plenty of water, up the citrus intake and come back in 3-months for a follow-up. Cost 2800 baht. Subsequently, I cancelled the CT scan!

 

Follow-up at private hospital 3-months later. Another ultrasound and it's still there, same place, same size, still asymptomatic. Same procedure, same advice, same 2800 baht. See you in April.

 

 

 

 

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Posted
41 minutes ago, NanLaew said:

 

I had a provisional diagnosis of a renal stone (slightly elevated RBC in urinalysis). When I asked the renal specialist for the ultrasound at the local hospital, he refused and said the CT scan was better, no argument. Went ahead and booked it, around 13000 baht, day after tomorrow.

 

The next day, visited a private hospital, explained the provisional diagnosis and their specialist recommended an ultrasound, carried out an hour later. This confirmed one, small renal calculi. Being asymptomatic, I was advised to drink plenty of water, up the citrus intake and come back in 3-months for a follow-up. Cost 2800 baht. Subsequently, I cancelled the CT scan!

 

Follow-up at private hospital 3-months later. Another ultrasound and it's still there, same place, same size, still asymptomatic. Same procedure, same advice, same 2800 baht. See you in April.

 

 

This highlights the differences between Private care in Thailand and public health care, in Thailand and / or in the UK (for example).

 

With private care, it could be argued that money is no object and all and any tests are carried out, this of course can be a good thing when investigation is carried out for anything no matter the cost... 

But, there are negative aspects to this as well... 

- Firstly the increased costs of insurance as unnecessary and expensive investigation is carried out.

- Money (hospital income) sometimes takes precedence over individual safety (and often inconvenience)

 

 

Not in Thailand, but elsewhere (private again).

- I had a growth on my leg...  Saw a Dr, he referred me to a surgeon who mentioned cancer and said he would cut a golfball size chunk from my leg and then send it for biopsy.  

I saw a second opinion from a dermatologist who identified exactly what it was (hemangioma) and treated it (cut it off) there an then (a very simple quick procedure).

 

What I learned there is that some Dr's / Surgeons will go straight to the knife option and lack full knowledge of their disciplines - as always, its ok to question, seek second opinions and be cynical of anything that doesn't make 100% sense.

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Posted

No, it does not make sense. 

 

When statin has suceeded in reducing LDL to normal level usual course of action is to keep the patient on the statin.

 

If the drug reduced LDL but it is still above normal options would be to either give it more time at same dose or increase the dosage/change the drug 

 

In neither case would it make sense to just stop treatment

 

Sometimes diet and exercIse alone will do the trick but not all patients are willing/able to make these changes. 

 

What exactly were her LDL numbers before and after? And what is her triglyceride? 

 

 

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Posted
2 hours ago, Sheryl said:

What exactly were her LDL numbers before and after? And what is her triglyceride? 

 

 

First test at end of October:

 

Chol    256

LDL      172

HDL      71

Tri         67

 

3 mos 20mg Sim daily, test end January:

 

Chol   168

LDL    80

HDL    70

Tri       89

Posted

Your

 

You are very concerned about your wife's health and unhappy  with the diagnosis and treatment at your local government hospitial. Why not bite the bullet financially and have her see a specalist at a private hospitial. 

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Posted
20 hours ago, NoDisplayName said:

....I play one on Thai-V.

 

Three months ago, the wife went to the local hospital for a check-up which included a battery of blood tests.  Results indicated LDL was high, and total cholesterol was very high (~250).  The doctor prescribed simvastatin 20mg for 90 days, and set an appointment for 90 days in the future.

 

Today was that day.  Honey-bunny fasted for 12 hours, we arrived at the appointed 7 am to get a number.  Around 7:30 she was screened and told the doctor would be there at 8:30.  We asked about a blood test, but was told the doctor would need to see her first.  Doctor waddled in at 9:30, and began speed-examining patients averaging less than 200 seconds each.

 

Honey-bunny was called in.  So exciting!  The doctor asked "how do you feel,"  then wanted to prescribe another 90-days of medication.  Wait, what?  No blood test?  I told honey-bunny to firmly request doctor to write an order for a blood test, to....you know, see if the medicine was having any effect before continuing treatment.  Doc didn't want to since it was already so late, already 10 am, but eventually did so.

 

Early afternoon, picked up results and returned to same doctor.  Total cholesterol had dropped massively, now well within recommended range, LDL lower but still a little high.  Doctor decided it worked.  No more simvastatin prescribed, and no follow up with blood test in 90 days.  Wait, what?  Now that you know the treatment is effective, you want to stop it?  And you're not concerned numbers will go back up again without medication?

 

So......continue medication without knowing the effect, but stop the medication with no further testing when it was shown to be at least temporarily effective?  Does this seem inappropriate treatment, or do I jus tink too mutt?

 

 

Without statins the cholesterol will go up unless your wife changed her life style: exercise, fatty fish like mackerel, brown rice, nuts, oats and veggies. And some more.🙏

Posted
20 hours ago, NoDisplayName said:

....I play one on Thai-V.

 

Three months ago, the wife went to the local hospital for a check-up which included a battery of blood tests.  Results indicated LDL was high, and total cholesterol was very high (~250).  The doctor prescribed simvastatin 20mg for 90 days, and set an appointment for 90 days in the future.

 

Today was that day.  Honey-bunny fasted for 12 hours, we arrived at the appointed 7 am to get a number.  Around 7:30 she was screened and told the doctor would be there at 8:30.  We asked about a blood test, but was told the doctor would need to see her first.  Doctor waddled in at 9:30, and began speed-examining patients averaging less than 200 seconds each.

 

Honey-bunny was called in.  So exciting!  The doctor asked "how do you feel,"  then wanted to prescribe another 90-days of medication.  Wait, what?  No blood test?  I told honey-bunny to firmly request doctor to write an order for a blood test, to....you know, see if the medicine was having any effect before continuing treatment.  Doc didn't want to since it was already so late, already 10 am, but eventually did so.

 

Early afternoon, picked up results and returned to same doctor.  Total cholesterol had dropped massively, now well within recommended range, LDL lower but still a little high.  Doctor decided it worked.  No more simvastatin prescribed, and no follow up with blood test in 90 days.  Wait, what?  Now that you know the treatment is effective, you want to stop it?  And you're not concerned numbers will go back up again without medication?

 

So......continue medication without knowing the effect, but stop the medication with no further testing when it was shown to be at least temporarily effective?  Does this seem inappropriate treatment, or do I jus tink too mutt?

 

 

Go see a dietician. They will give you a detailed diet plan. Best way to fix your health.

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Posted

ahhhhhhh   you fell victim to the Big Pharma scam

CHANGE THE DIET !     drop the carbs  go carnivore for  90 days  Beef Butter Bacon Eggs  "High Fat "   

LDL don't mean jack squat ..   did they do a particle size   ?  probably not !

 be more concerned about HDL to Tri Gly  ratio

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Posted
12 minutes ago, Luuk Chaai said:

ahhhhhhh   you fell victim to the Big Pharma scam

CHANGE THE DIET !     drop the carbs  go carnivore for  90 days  Beef Butter Bacon Eggs  "High Fat "   

LDL don't mean jack squat ..   did they do a particle size   ?  probably not !

 be more concerned about HDL to Tri Gly  ratio

this is one of many that may help clear things up for you or anyone that is confused

 

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Posted
1 hour ago, NoDisplayName said:

 

First test at end of October:

 

Chol    256

LDL      172

HDL      71

Tri         67

 

3 mos 20mg Sim daily, test end January:

 

Chol   168

LDL    80

HDL    70

Tri       89

OK. Her situation is actually a bit complex and not straightforward.

 

(Talking just about the original values, since the repeat tests reflected the effect of the now discontinued statins):

 

- HDL and triglycerides are excellent

-cholesterol ratio is 3.6 which is also pretty good (below 3.5 is ideal; high is when it is over 5)

- Very likely the LDL measure was indirect, not direct. That means calculated by an equation rather than actually measured. When the triglycerides are low (as in her case) these indirect measures can be unreliable.

 

So in fact the first step should be to get a direct LDL test. Then, if it is still elevated,   -- since it is possible that her LDL elevation is coming from large particle LDL i.e. healthier fats -- see a specialist in lipid disorders to discuss whether in fact her lipid profile needs treatment.Presence or absence of other risk factors will play a role in that decision.

 

Where are you located?

 

 

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Posted

My cholesterol was high the past few years.  Doctors in USA told me to watch my diet.  My diet hadn’t changed but I made some changes.  Still no improvement. 
When I moved to Bangkok about four years ago I had my yearly physicals at Bumrungard  Hospital.  With all necessary medical treatments.  Since the cholesterol issue was not related to diet I was sent to see an Endocrine specialist. 
She put me on Livalo a statin.  That quickly reduced my cholesterol and maintained it at a normal level.  
I had to get blood work every three months.  Not only do they want to see if it’s working.  The statins can have a chemical adverse effect on the muscles.  So it has to be monitored.  And any muscle aches should be reported to the doctor.  And also of course it’s monitored to make sure it’s maintaining the cholesterol level properly. 
I was first put on a non statin , then a statin that didn’t work well. 
I also suggest she takes Coq 10  supplement to try to prevent any muscle aches or keep it minimal. 

Posted

1) Sounds like a government hospital,

2) Given meds and then told they're no longer needed without mentioning a change of diet or exercise??

3) She needs to be proactive and either start eating healthier or consult a dietician and come up with a exercise routine.

 

Posted
46 minutes ago, Sheryl said:

OK. Her situation is actually a bit complex and not straightforward.

 

(Talking just about the original values, since the repeat tests reflected the effect of the now discontinued statins):

 

- HDL and triglycerides are excellent

-cholesterol ratio is 3.6 which is also pretty good (below 3.5 is ideal; high is when it is over 5)

- Very likely the LDL measure was indirect, not direct. That means calculated by an equation rather than actually measured. When the triglycerides are low (as in her case) these indirect measures can be unreliable.

 

So in fact the first step should be to get a direct LDL test. Then, if it is still elevated,   -- since it is possible that her LDL elevation is coming from large particle LDL i.e. healthier fats -- see a specialist in lipid disorders to discuss whether in fact her lipid profile needs treatment.Presence or absence of other risk factors will play a role in that decision.

 

Where are you located?

 

 

 

We'll be doing some more reading on this.

According to both reports, LDL was calculated.

Located in a small town outside Korat.  Will have to see what sort of specialists are available in the big city.

Posted
5 hours ago, NoDisplayName said:

 

First test at end of October:

 

Chol    256

LDL      172

HDL      71

Tri         67

 

3 mos 20mg Sim daily, test end January:

 

Chol   168

LDL    80

HDL    70

Tri       89

 

I can tell you now that many progressive doctors would not blink at those numbers in October. HDL and Triglycerides both very good, and LDL, quite frankly, nothing to worry about. Higher than what the medical profession used to be comfortable with but hardly sky-high.

 

In the January numbers, her Triglycerides are worse (but still fine) - they have gone from stellar, to good. The LDL is, frankly, too low!

 

Plenty of modern doctors want to see LDL in the range of 120 - 300. Your wife went from within that range to outside that range. Sorry, this is not what you wanted to hear and I am not a medical doctor nor do I have any medical training. I do, however, follow current medical research and commentary very closely.

 

Posted
On 1/31/2024 at 10:31 PM, NoDisplayName said:

....I play one on Thai-V.

 

Three months ago, the wife went to the local hospital for a check-up which included a battery of blood tests.  Results indicated LDL was high, and total cholesterol was very high (~250).  The doctor prescribed simvastatin 20mg for 90 days, and set an appointment for 90 days in the future.

 

Today was that day.  Honey-bunny fasted for 12 hours, we arrived at the appointed 7 am to get a number.  Around 7:30 she was screened and told the doctor would be there at 8:30.  We asked about a blood test, but was told the doctor would need to see her first.  Doctor waddled in at 9:30, and began speed-examining patients averaging less than 200 seconds each.

 

Honey-bunny was called in.  So exciting!  The doctor asked "how do you feel,"  then wanted to prescribe another 90-days of medication.  Wait, what?  No blood test?  I told honey-bunny to firmly request doctor to write an order for a blood test, to....you know, see if the medicine was having any effect before continuing treatment.  Doc didn't want to since it was already so late, already 10 am, but eventually did so.

 

Early afternoon, picked up results and returned to same doctor.  Total cholesterol had dropped massively, now well within recommended range, LDL lower but still a little high.  Doctor decided it worked.  No more simvastatin prescribed, and no follow up with blood test in 90 days.  Wait, what?  Now that you know the treatment is effective, you want to stop it?  And you're not concerned numbers will go back up again without medication?

 

So......continue medication without knowing the effect, but stop the medication with no further testing when it was shown to be at least temporarily effective?  Does this seem inappropriate treatment, or do I jus tink too mutt?

 

 

Manage the testing yourself. I have haemochromatosis and need to check iron levels regularly. There is one haematologist on the island of Phuket and she uses google to answer your questions and figure out her treatments. So I stopped seeing her and manage it all myself. Getting a cholesterol test in a lab is a few hundred baht and takes less than a day. If you do there same test in a rort hospital like bkk the same test would probably be at least 2000b.

Do the tests and then present them to a real doctor if you need medication or something.

Posted

Fact is doctors dont tell you anything more then just regular bla bla.

They give you the "medicine" and thats it. YOU have to figure out what problems you get with taking it.

I had simvastine but had some weird effects. Didnt know, even my doc, didnt think about it.

After 6 months, I had terrible headaches. Doc says migraine, probably right, but it was because of statines.

It took some time for me to realize, headache and medicines. After stopping with statines, I had no more headaches !

 

Back to doc and told him ! He send me to specialist, who gave me OTHER statines, but all with the same effect.

The last one I had, gave me such a headache, I wanted to kill my self. It took 4 days to max headache.

I told the specialist to shove it down his ass. No more. I think they go down a line of first statines and maybe late another then?

 

I red on internet statines break down muscle, Q10 enzym and many other things. Found a movie, consumer program in my country from 2008 with quite a bunch of people having serious problems with statines. Even people who couldnt walk anymore.

 

I red about curium and started that. Had it sometime and blood sample was 3. I asked specialist, is it working?

NO he said, bbb but my value is down, why? Placebo effect? maybe he said.

Kept taking it and value was 3 again in next sample. He told me didnt work, but still 3. My own body working then?

No clue, no answer then only NO from specialist.

Kept taking it until I experienced headache again, be it way less. Stopped it, meant stop headache.

Damn, I had such good hope. OK didnt try to lower the dose, had just 1 spoon /day. Maybe half a spoon?

Nowadays I dont know , should do a sample again. I know with first sample ever it was 9.

BUT Im sure not ever going back to statines ! Then I better stop living.

Of course all depends on persons, individual which effects turn up. YOU MUST monitor your body well !

AND it can turn up after even 6 months, shorter or longer maybe and it can be anything.

 

I ve red comments about statines, from doctors, they say it is BS and just big business.

They found out this drug was lowering cholesterol and the limit by research, I think, was common 2 (testing many blood samples on cholesterol) and therefor all people should be on 2. If I red well , cholesterol can oxidize and therefor with oxidation other oxidation substances, are creating scaling on your veins.

If you lower cholesterol of course less oxidation and less scaling. But is it right? You should have an medicine preventing the oxidation.

That woud be logical. Maybe it is there, but they use statines instead for lowering. Big business.  

 

Im not a doctor, Im a patient. A doctor can be help full, but sometimes you have to figure it out yourself.

Internet is help full, got info from it. Youtube where you can find out about medicines, statines.

But always have an open mind in seeing those movies, and think yourself. 

A doctor is working in a box and sometimes not aware out of the box. He should be, but ...

 

Not long ago, a doctor surprised me. He was really spitting on the corona medicines.

He probably had a thought full day, overthinking about the vaccines and explained, complained about it. How they did wrong with those vaccines.

He was quite short technical in it, but with what i red, it was really bad. Red it several times, too make sure what I was reading.

For me it was amazing to read and I regret taking Pfizer, instantly. Cant undo anymore and hope for the best.

Also about flue vaccines, same wrong method. He recommended NOT to get those shots as well.

2 companies getting filthy rich and still delivering toxic. 

 

Have 2 pils for blood pressure, took them long time both at the same time. I got an increase of weight.

I asked pharmacist, can I have them separate?  Could, I did and weight go down again.

Amazing, after long time having them together.

Track your body when having that candies, it can be good for one thing but bad in another way.

For one person it works fine, for another it is hell.

  

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Posted
On 2/1/2024 at 1:14 PM, NanLaew said:

 

I had a provisional diagnosis of a renal stone (slightly elevated RBC in urinalysis). When I asked the renal specialist for the ultrasound at the local hospital, he refused and said the CT scan was better, no argument. Went ahead and booked it, around 13000 baht, day after tomorrow.

 

The next day, visited a private hospital, explained the provisional diagnosis and their specialist recommended an ultrasound, carried out an hour later. This confirmed one, small renal calculi. Being asymptomatic, I was advised to drink plenty of water, up the citrus intake and come back in 3-months for a follow-up. Cost 2800 baht. Subsequently, I cancelled the CT scan!

 

Follow-up at private hospital 3-months later. Another ultrasound and it's still there, same place, same size, still asymptomatic. Same procedure, same advice, same 2800 baht. See you in April.

 

 

 

 

A renal stone is not really a peoblem unless if gets quite large. The problem is when it decided is wants to leave your body and get stuck in the ureter. I've had a few of them. The last one taking a few months to exit. The bet way to ensure one doesnt get a problem is to drink >2 liters of water a day, everyday. I just can't manage that!.

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