Hello!
From browsing the healthcare section of LYN forums, I notice that many forumers are asking for medical advice on different conditions/illnesses. Some advice are good advice, some are common sense, and others can be very bad advice which can lead to bad outcomes.

Therefore, I'm taking the initiative to start a topic where health care workers can give their advice/opinions to different needs or questions from forumers. The idea is to link all healthcare professionals here with people who may benefit from their expertise in one topic.

TAKE NOTE THAT THE ADVICE GIVEN HERE IS NOT MEANT TO REPLACE A FORMAL CONSULTATION BY A QUALIFIED DOCTOR AND THE CONTRIBUTORS HERE CANNOT BE HELD RESPONSIBLE FOR ANY MISHAP THAT MAY OCCUR AS A RESULT OF ADOPTING OR NOT ADOPTING THE ADVICE GIVEN.

There are limitations: we cannot examine you for any physical signs. This topic is only meant to give a general idea of the condition and to screen for serious illnesses.

To those who are interested in giving advice here, please state your designation (doctor, medical student, nurse, etc) and your area of specialty/interest (medical, orthopaedics, O+G, etc)

It is my hope that the LYN community may benefit from this.

List of Healthcare Professionals active in this thread:

Feel free to post here and we'll try to get back to you ASAP.

This post has been edited by aeternalis: Sep 17 2011, 05:27 AM

Name: <I prefer other forumer to call me as stated on my nickname.>
Designation:House Officer
Area of interest: Medical Dept, Emergency Dept.

This post has been edited by Mr.Docter: Dec 6 2015, 09:11 PM

Hi, I need some advice on my thyroid prob, had been taking camazol for a year. N my doctor said it's better if i go for a thyroid gland removal surgery since I can't rely in this medi for long term. Should I? I an so afraid of d side effects from d surgery, such as lost vocal voice, can't get pregnant in future n etc etx, n I oso donno which hospital to go in kl which is more reliable, any advice? Fyi, I'm lacking tsh hormone....

Name: zstan
Designation: Pharmacy student
Area of interest: Clinical pharmacy

Hope to learn from everybody here

Err. I believe you have hyperthyroidism, which is why you're on carbimazole (generic). But you're making it unclear at to which type of cause it is, whether thyroid tumours or the autoimmunes (I'm assuming it should be the more common ones in young adults). And the surgical procedure would be to remove the lobes to reduce the over-production of the thyroxine (T4) hormone. I'm not sure if TSH plays a part in your condition unless its pituitary adenoma. And that requires another surgery to another anatomical part. Or radiotherapy.
The thyroid tumours are another different ballgame altogether so I'm not making any assumptions here.

Has no doctor advised you for radioiodine therapy instead? It should be a viable route also.

If for surgical route, I would advise to find for ENT specialists who do thyroid glands, they should work quite delicate and more discriminate in this matter. Sorry I can't recommend anyone as I have no idea who's who in KL, but the general advice is what I've gleaned from observing the surgical considerations the surgery teams do.





This post has been edited by trencher10: Sep 5 2011, 09:42 AM

Hi zstan,

You are in which year currently?



This post has been edited by Mr.Docter: Sep 5 2011, 11:22 AM

Hi karenkow,

Low TSH means that it is due to negative feedback from your overproductive thyroid gland to produce T3 and T4, which is in other word - Primary hyperthyroidism. There are several causes of primary hyperthyroidism (you can just wiki it by yourself actually for an extra reading) and most of it involve either surgery or specific destruction of hyperactive thyroid tissues using isotope (contraindication - during or planning for pregnancy in shortest time) .

The side effects as you already stated above are the potential complication, which is not uncommon especially hoarseness of voice due to the damage of the laryngeal nerve and its recurrent. But total lost of vocal nowadays is uncommon because improved technology and skills. You may undergo linguistic physiotherapy about a months if you face those problem post-operatively.

Regarding pregnancy, you just need to consult your doctor for an increment of dosage by time. There would be a tight schedule compared to the normal dosage that you take after the operation, relatively. Adherence to medication and its specific dosage as suggested by your doctor play an important role in the situation.

Lastly beware of thyroid storm. This is not under your (patient) role but more to the surgeon instead. Pre-operative preparation is vital for thyroidectomy.

SPOILER : Picture of removed thyroid gland due to malignant tumor.


This post has been edited by Mr.Docter: Sep 5 2011, 11:26 AM

Yeah they told me abt radio therapy as well, but bcz of my gland had swollen, so d doc said better go for surgery, but due to d doc I consult now is d normal clinic doctor, nt a specialist in thyroid or surgery, so really need more professional opinion on this. Ofcoz im going to look for.a specialist on thyroid b4 really decided on operation.... Thanks for ur info it's really helpful :-)

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Added on September 5, 2011, 11:54 amHi, thanks for d info, really helpful b4 I make any decision. Seem like I gt no othrr choice than go for a surgery :-(

Bt I still have to take pill to replace my hormone after surgery right?

What's really bothering me is which hospital to go, it might be a small operation for doctor but it could be d biggest to me in my life, so really afraid to make a wrong decision in choosing hospital... Any suggestions on which hospital or doc which is really good on thyroid problem?


This post has been edited by karenkow: Sep 5 2011, 11:54 AM

>swollen gland = better perform surgery since it will fix the hyper-functional state and cosmetic aspect as well.

Yes, its vital for you to adherence to your medication as an hormonal replacement. But looking at your history in rough, you'd already familiar with the pills (carbimazole). Being hypothyroid state is dangerous as you skip your medication.

Hmm I am personally do not familiar with hospital in Malaysia as I am an overseas student. Kindly consult your doctor for their specialist recommendation.

If your glands are swollen, it not necessarily means a surgical route is a given. However, this is due to the fact that I still have no idea what type of hyperthyroidism you have as the symptoms list is still short for me to assess. Plus, if this is an acute inflammation of the thyroid tissue, rather than hyperplasia, even surgery will have to wait medical management first.

Regarding carbimazole continuation, this is dependent upon your T4 levels and the extent of the thyroid tissue removal that they do (and there will be another complication with para-thyroid glands as well, if they were removed as well). The doctors will monitor your T4 levels and try to achieve a euthyroid state without requiring medication.

Thyroid glands removal is quite routine (general surgeons also can & do this surgery, and sometimes the cardiothoracic teams are called too when they have thoracic thyroid tissue to deal with), but which is why I recommended searching for ENT specialists as they are the people most discriminate with the throat area.

Lastly, good luck and hope you'll be in best of health.

Ya.... I act tried to stop d medi 1 month, but d anxious n hyper symptoms all came back, can't really get sleep at night but shin felt tired in d morning, my doc said it's mean it's come back very fast... Coz initially we plan to try stop for 3 mths, if my.body can produce d tsh hormone without d medi, msybe I can escape from d operation, but obviously it's not work for me...

Really thanks for ur advice, I felt more relief now coz it seems like a common surgery... hope things get better after surgery... Cheers ;-)

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Added on September 5, 2011, 6:57 pmThanks thanks, so meaning to say it's nt necessary for d same doc to observe me to do d operation for me as well? I mean d thyroid specialist might nt d one do d operation for me?


This post has been edited by karenkow: Sep 5 2011, 06:57 PM

It sound better, but actually its not necessary.

The referral later from your current GP to the doctor that will perform the surgery will be sufficient


I don't think we have thyroid specialist, in specific. I don't think you should worry this part. Make sure you go to the respected hospital since management over there is relatively better.

This post has been edited by Mr.Docter: Sep 5 2011, 07:29 PM

Hi guys! Thanks to Mr. Docter and trencher10 for their input. Was on-call so didn't post recently. Glad to see that the ball is already rolling.

To karenkow: Good advice from them so far. Just a few things to add. Any surgery will have potential complications. You need to weigh the pros and cons of doing any procedure. That being said, it's rare nowadays to see the more serious complications such as losing the voice, etc.

I think the 'thyroid specialist' you are seeing is probably an endocrinologist (doctor expert on hormone related disease). The person performing the surgery is either an ENT surgeon or a general surgeon. So the person who you are seeing most likely won't be present for your surgery.

Thyroid surgery is very commonly done, so most surgeons will have plenty of experience.

As for the choice of where to go for surgery: one main factor is whether you want to do it in a private hospital or a public hospital. This will differ in terms of cost.

If you go to a private hospital, the cost will be high but you will get a specialist surgeon to perform the procedure for you.
If you go with the public hospital, you are not guaranteed to get a more senior or experienced surgeon. Sometimes, more junior medical officers will perform the surgery under the guidance of their seniors. But the cost of the operation and stay will be much lower.

If you want, I can enquire about the cost of the surgery from a private hospital and public hospital during office hours tomorrow.

Well about hospitals, you can cross out gleneagles. Te prices there are exorbitant. There's this dr siti who's an endocrinologist at Sunway medical if I am mistaken. But she's a physician not a surgeon if I can remember correctly.

Is thyroid surgery covered under insurance? Do you even have health insurance in the first place?

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Added on September 5, 2011, 11:08 pmFor public hospitals, you can be assured that the maximum cost of your operation and stay there(excluding medications) will not exceed rm500 based on my experience there last year during my attachment. Not sure whether prices have increased. But how long more can you wait? That's te golden question.

This post has been edited by zstan: Sep 5 2011, 11:08 PM

Ahhh endocrinologist! that's the keyword that I been searching for somewhere in my brain. It is more precise compared to ENT when we talk about thyroid gland

Hi,

first year 2nd sem only.

Oh, but you have a knowledge like a final year student!

Nice knowing you.

Haha. I've still got a lot more to learn la.

Nice meeting you too.

Hi aeternalis.... Thanks soooo much, I get so many useful information here, really appreciate it :-)

Yeah that's what I'm worried if go government hospital, but if private r too exp then I've to... :-(

It's will be really nice of u if u can get d price of d surgery to me, at least I can have a rough budget on it....

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Added on September 6, 2011, 10:52 amHi tan, hmm too bad my.insurance din cover for me cz when I gt this policy I ord under medication. But I wonder if my.company medic card can cover for me..... :-(


This post has been edited by karenkow: Sep 6 2011, 10:52 AM

I would also suggest if you could glean info on their surgical considerations as well, if they actually leave it to the ENT team or general surgeries. Especially the public hospitals. In my place, even in the public hospitals the consultant specialists are adamant in this matter. Plus, internal word-of-mouth is a great way to know where the best public hospital specialists are located.

This post has been edited by trencher10: Sep 6 2011, 12:22 PM

Oh Nola if you go private they can try to help you get insurance one for the surgery and hospital stay.

The calculations for whole period of stay is quite easy to count la actually.

Since thyroid surgery is quite simple which will take maybe 1-2 hours, charges most probably will vary from 1-5k. Depending on docs reputation.

Anesthesia will cost around 200-600 depending on doctor.

If you stay in a 4 person ward it will most likely cost less than 100 or maybe slightly more(depends on hospital) per night. 2 person ward will be more expensive and single ward will be the priciest.

The charges of doctor when they visit you during your stay will probably cost from 0-500. Also depends on how money minded is your doctor.

After including medications, your total cost may vary from 3-7k, depending on doctor and hospital.

My 2 cents la.

Ahhh.... Icic, it's really clear info! Love it! So u said skip glean, how abt prince medical?

Prince court should be having the same price range as Sunway gua. Maybe cheaper than SJMC? If you can afford it, try to go to see a few doctors and compare their prices. You are the patient you should know your rights.

Try to compare prices between Sunway/SJMC/Prince/maybe Tropicana...if really cannot afford there can go slightly cheaper places like KPJ group of hospitals(Tung Shin/ Damansara) or Assunta...

http://valor.com.my/downloads/hospital_admission_charges.pdf

The link above is a list of the room charges of major private hospitals in Malaysia. However only one of this hospital put the cost for total thyroidectomy around RM5000 - RM10000 under Puchong Medical Centre, non inclusive of hospital stay, nursing charges, equipment charges. The other hospitals will offer thyroid surgery also, but they didn't list down the charges...

Prince Court is in this list I linked you, but again the surgery cost not listed.

i think it's super dangerous to take advice from forumers here...
Well, since there's no establish diagnosis for your condition, there's very little information here and all these while you've been managed by a GP...

To be on the safe side, go and see an endocrinologist first before any further decision.
You need further investigation on your thyroid ds.
Yes, you're definately hyperthyroid judging from your symptoms and presentation, but the underlying cause must be investigate before further management.

to the med students here...
I think it's important to establish a sets of differential diagnosis before you give advice to your patients in future practice.
Misleading information could lead to lots of stress and anxiety to our forumers...

example :
Hi, thanks for d info, really helpful b4 I make any decision. Seem like I gt no othrr choice than go for a surgery :-(

When a pt failed medical treatment, something to ponder in our mind :

1) what cause the treatment to fail ? incorrect diagnosis? non compliance to medication? drug drug interaction? or inadequate therapy.
Bear in mind that the treatment has been started by a GP...
plus, we don't even know the TSH/T3/T4 trending on treatment over the year.
How low is low?
So, you should ask her to provide these valuable information before further decide whether or not this is truly a failed medical treatment.
we don't even know whether pt's on maximum dose of carbimazole etc.
Maybe she's just on chicken dose started by GP...who knows?


2) You should also ask for associated symptoms and well known complications which is associated her thyroid problem.
eg: thyroid eye ds, AF...
should any of above present, she should immediately seek a specialist review.

Dear Karen,

I think u seriously need a specialist review, they are available in any general hospital/university hospital.
You may want to speak to your current doctor to provide a detail medical report/referral.
Bring your medical report/blood reports along and book an appointment.

You may not need to worry about surgical review for now as judging from your progress, you responded to the previous treatment, it just tat it rebound back quite fast.

There's pt who r on medical treatment for years before opted for surgical intervention.

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Added on September 6, 2011, 8:33 pmi think it's super dangerous to take advice from forumers here...
Well, since there's no establish diagnosis for your condition, there's very little information here and all these while you've been managed by a GP...

To be on the safe side, go and see an endocrinologist first before any further decision.
You need further investigation on your thyroid ds.
Yes, you're definately hyperthyroid judging from your symptoms and presentation, but the underlying cause must be investigate before further management.

to the med students here...
I think it's important to establish a sets of differential diagnosis before you give advice to your patients in future practice.
Misleading information could lead to lots of stress and anxiety to our forumers...

example :
Hi, thanks for d info, really helpful b4 I make any decision. Seem like I gt no othrr choice than go for a surgery :-(

When a pt failed medical treatment, something to ponder in our mind :

1) what cause the treatment to fail ? incorrect diagnosis? non compliance to medication? drug drug interaction? or inadequate therapy.
Bear in mind that the treatment has been started by a GP...
plus, we don't even know the TSH/T3/T4 trending on treatment over the year.
How low is low?
So, you should ask her to provide these valuable information before further decide whether or not this is truly a failed medical treatment.
we don't even know whether pt's on maximum dose of carbimazole etc.
Maybe she's just on chicken dose started by GP...who knows?


2) You should also ask for associated symptoms and well known complications which is associated her thyroid problem.
eg: thyroid eye ds, AF...
should any of above present, she should immediately seek a specialist review.

Dear Karen,

I think u seriously need a specialist review, they are available in any general hospital/university hospital.
You may want to speak to your current doctor to provide a detail medical report/referral.
Bring your medical report/blood reports along and book an appointment.

You may not need to worry about surgical review for now as judging from your progress, you responded to the previous treatment, it just tat it rebound back quite fast.

There's pt who r on medical treatment for years before opted for surgical intervention.

This post has been edited by klifex: Sep 6 2011, 08:33 PM

Hi, ya I plan to do so. Which definitely will seek for doc advice b4 really go for surgery, n might even more than 1 doc advice.

Arhhh... Do not blame them for giving me those advice b4 further asking my further conditions, in fact I din really provide enuf info as well, act just wanna looking for some advice or word of mouth which hospital or even which doctor is good in my case, since im nt really familiar with all these. All d info im getting here is act very helpful, at least now I know thyroid removal surgery is a common surgery, ofcoz its various depends on d patient conditions. N also some hospitals n medical center I can consider, b4 this I only knew glean, prince, n few government hospitals.

Again I really appreciate n wanna say thank you to all of u guys, as a patient its really terrified if we do not know anything abt d disease we facing, ur advice might nit 100% accurate but its definitely ease my tension ;-)

Dear klifex and everyone that posting in this thread, hope you guys can read, re-read and understand the Rules and Regulation in this Health & Fitness sub-forum as well as the first post in this thread before commenting

Even if it's a major surgery it still cost RM500? If a private hospital charges RM20,000 for a particular surgery, that same surgery can be done at government hospital for RM500?

As far as I am concerned, yes. You can stay there for months and still charged the same price.

However, I think you should know te draw backs...long waiting period...bad ward conditions(most wards do not have air cond) and you will be sharing 8 wards per cubicle with no proper partitioning..food is bad...you will be guinea pigs to the housemen on duty there at will...

Worse thing is if something goes wrong (none life threatening or become disabled)...for example housemen dunno how to take blood..need to puncture your veins a few times..you really have no where to complaint because you are already paying such cheap prices!

Dear Klifex,

Your concerns are genuine and is the main reason why I started this forum topic in the first place... I have come across many LYN health topics where layman give so called advice to forumers regarding their health condition.

I already explained in my first post that what is discussed here by no means should replace a formal consultation by a qualified physician (endocrinologist in this case). Also, I clearly stated that there are limitations: we don't have a complete history, we cannot perform a physical examination, etc.

My intention in starting this topic is so that forumers like Karen can get a basic idea of their disease, and give general advice to help them! No where in our replies have we advised her to start any specific form of therapy or recommended any one treatment over the other. We merely gave her some insight about her condition and enlightened her about her options within the Malaysian Healthcare system with advice to seek further specialist help about her condition.

From your reply, I can tell that you're probably a physician as well. Well indirectly, from your reply you are actually giving Karen advice from a 'forumer' as well aren't you? Which is exactly what I purposed this topic for in the first place: for medically trained healthcare practitioners like us to give some general advice to sick people and educate them about their disease!

I see no harm in some patient education. At least we're more 'qualified' than some of those forumers out there who are already giving their two cents worth, based on what their mother said is right or their various cultural practises. Irregardless, I welcome your contribution to this post and I hope that you will continue to post here. I can see many people benefiting from your advice, including myself.

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Added on September 7, 2011, 5:34 pmIt's true that going to public hospitals does have its drawbacks... But the healthcare cost is heavily subsidized! Imagine, only pay RM1 in clinic and you get those medications outside will cost hundreds of dollars. Not every public hospitals will have house officers (junior doctors) though. Only the bigger hospitals like GHKL, UMCC, Klang, etc... Small places like Hospital Bukit Mertajam for example do not have house officers training there.

Otherwise, what zstan said is true... long waiting times, packed wards, etc...

But houseman training must start from somewhere right? Even the most accomplished surgeon or physician was a houseman once upon a time. Won't be so bad one lar, most house officers will develop their skills fast unless really junior junior like first day at work, then definitely got problem. Even more so now that Housemanship training is 2 years. Those senior houseman are quite proficient in things like taking blood, setting lines, etc.

As for the maximum ceiling cost of RM500; not always true though. For example, those orthopaedic surgeries where need to purchase third company implants like intramedullary nails they sometimes charge the patient more. But yeah, the cost will still be much cheaper than private hospitals.

This post has been edited by aeternalis: Sep 7 2011, 05:34 PM

Yeah.... It's act much better to seek for advice from diff source, here definitely one of it. It's even some details that I didn't get from my company panel doc. U know some time we went clinic bt we tent to forget something to ask even we had d question in our mind, n clinic normally they have a lot of patient waiting, so I can't really get a lot of info as well.

I just gt to know that I might can claim insurance on this surgery, so I'm planning to go private hospital, gleneagles maybe? I search their website gt few number of general surgery docs, I'm nt sure which one to consult, any recommendation? Cab pm me if it's nt too good to tell d name here..

Thanks again....

Ah yes, i should say maximum RM500 for surgery fees only (excluding medications AND implants).

As i know, the stents and cathether used for Angioplasty can cost up to a whooping Rm10,000!

Anyway Karen,

Choose a hospital which is close to your residence. In case you have family members who wants to take care or visit you it wouldn't trouble them too much.

hey... great thread....

Name: Dr Barb
Designation: Oral Surgeon
Area of interest: minor oral surgery

Hi to all doctors here,

I would like to know what's is the long term effect of eating raw food to our health?

No animal products, only raw organic vegetables?

Are you referring to nutritional long-term effects, or safety effects of ONLY consuming vegetables? I see no problems in eating properly-prepared (washed) raw organic vegetables. As to benefits, I've yet to see the data really ...

This post has been edited by trencher10: Sep 8 2011, 01:14 PM

Not a doctor,

But do you mean you only eat vegetables alone and nothing else?

Name: Joshua
Designation: Physiotherapist
Area of interest: Neurology and musculoskeletal

edited - can PM me if you have any queries.

This post has been edited by paqralos: Sep 8 2011, 04:37 PM

Hello to Dr. Barbarian and paqralos! Thanks for joining this little thread of ours...

I will be editing the first post to include all our participants and their designations so that its easier for people to seek advice from the right people.

Hey chief,

Ur trying to give consultation here or ur trying to pick up chicks?? If u like zstan just PM her la. No need mushy mushy here. Haha..

I think my male tag there is quite clear right?

oops..haha. but still does not rule out attraction of same sex. haha..just kidding. Sorry didnt realize ur a male. overlooked from the pic.

There can't be possibly any wronger than this wrong interpretation.

Anyway, starting from Dr Ben; do you have any general information or whatsoever that will practically came handy for medical student once we be posted to your respective department (Anaesthesiology)?

Lets keep the sharing rolling

This post has been edited by Mr.Docter: Sep 10 2011, 09:28 PM

One thing about Anesthetist... i really hope newly trained ones..or maybe the current ones can be more professional..

As the current trend goes..most of the anesthetist..after they have done their job, all they do is just sit in the ward playing with their ipad or laptop while the surgeon and others are busy treating the patient on the table. Once the operation is over, they just turn off the anesthesia and go off. They didn't even bother to monitor the blood pressure or any response of the patient...well that's what i witnessed during my attachment...

Anesthetist or aspiring ones alike...please prove me wrong...

Hah.... The ones I used to work with, will leave the ot for tea break once the pt goes under!!!!!

If I'm not mistaken, regulations call for an anaesthetist to be present in the OT at all times during an op. Going to tea break and having someone else cover should always be the case. Ada spital anaesthetist pegi joli makan minum x kesah op ka?

Junior/student will be there lor....

Alah, junior anaesthetist ada kira ikut protokol lagi laa. Igt biar mesen jalan sendiri.

A good thread here.....


Name: drthein71
Designation: Physician and Gastroenterologist
Area of interest : internal medicine, Gastroenterology,endoscopy,hepatology

Can pm me if required

Wah, i didn't post for a day you guys kutuk us anaes people nicely... hahaha. Hmmm, answering to Mr. Docter, for a medical student going for anaes posting, the bread and butter of our discipline is physiology. Especially Respiratory Physiology and Cardiovascular Physiology. It's good to learn the common drugs used in emergency and familiarize yourself with the protocols in managing common emergencies like cardiac arrest, etc... also brush up on your CPR skills. Anaes is fun!

Haha, for the rest of you guys... We only go for 'tea breaks' usually for cases under Spinal Anaesthesia when the patient is still awake and spontaneously breathing. This also we will always leave either an anaes house officer or another MO colleague. We take staggered breaks la! We don't usually leave patient unattended wan wei... dunno about your facility, maybe they too terror already, so slumber.

As for playing with Ipad... someone sponsor me an Ipad first la! The next thing is you can't expect our eyes to be glued to the monitor for a 6 hour laparotomy right? Look at the monitor until go crazy... Thats why we rely on our ears as well... We listen to the tone of the SpO2 beeping to tell us whether 100 or dropping to 99, 90 etc... Then when the automated BP give us the beep, then we will look up to note the BP lor... Alarms are our friends in anaes. I usually will take a medical book and read lor during these times. Never can learn too much one.

Hope you guys have a better understanding and acceptance of us poor group of misunderstood doctors who are force to sit in the cold ICU and OT all day long...

Sometimes, the anaesthetists has the time to tutor the students than the obviously busy surgeons!

Thank you very much for the input. I never went to OT in any of Malaysian hospital, yet. Most of my surgical cases I took was from Egypt, where the those anesthetist never leave their post. They keep on waiting and monitoring the vital sign and everything that I don't fully understand yet. Never saw them playing with iPad or leaving the OT at all.

After some sharing from zstan, DrBarbarian and others, now I understand what does zstan mean by hope the newly one or the current to be more professional.

Name: Dr. edge85
Designation: Dental Officer
Area of interest: Oral Surgery

The last time I saw a urological surgery (nephrectomy) went wrong I saw no drama-like ER moments. When the surgeon pulled off a part of the renal arteries close to the aortic wall (big TCC [and I thought the surgeon ruptured a big renal cyst or something at first]), the blood spurting out the cavity was already the alarm for the anaesthetist to go and bring in the G&H (or was it crossmatch?). I think the anaesthetists I've observed were always obesrvant of the operation regardless whatever they were doing. Though I doubt playing Angry Birds with the volume on is acceptable!

An interesting note, when the surgeon asked what type of cancer could it be, I proffered the initial opinion that it was a TCC as opposed to a RCC to the surgeon, but he disagreed ( I too knew that RCC would have been more common, but the involvement of the ureter made me decide on TCC ). Hooray for good guesses! (thankfully also, it's not the more ridiculously rare histological types)

Hi,

I heard from some GPs that there is a doctor from Gleneagles Ampang whose name is Dr. Ryan and he is the best Gastroenterologist in Malaysia. Is it true?

He's Datuk Dr Ryan. He is both in Prince Court Medical Centre and Gleneagles as well & he is good.

We anaesthetists are an misunderstood bunch. Anyway, wish me luck guys... i'll be going for an MRI tomorrow for my knee. I have a right ACL tear for the past 9 years: really giving me trouble now.

Seeing a sports surgeon in Penang GH on Thursday to schedule an op!

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Added on September 13, 2011, 10:07 amWelcome Edge85!

Wow, we're getting more an more ppl in here... Maybe we can start our own LYN hospital soon!

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Added on September 13, 2011, 10:28 amHello rosamundwo,

The person best suited to answer your question would be a dietitian, hopefully we'll get one to join us in this topic. Anyway, I'll try to answer your question as best I can. Are you a vegan? meaning you want to eat only raw organic vegetables with no animal products?

Well, being a full vegetarian is associated with increased risk of developing anaemia (due to iron deficiency and vitamin B12 deficiency). Of course, there are many vegetable sources that are rich in these vitamins and minerals so being vegetarian doesn't automatically make you anaemic: you just need to choose carefully what you eat! My colleague is a full vegetarian and he's pretty healthy.

Another part of your question is whether raw organic vegetables has any long term effect on our health. Well, we all know that cooking vegetables for long will denature (or destroy) some/most of the valuable elements stored in our greens depending on how long you cook it. But you must also know that cooking vegetables will also destroy all the harmful micro-organisms that may be present on our vegetable.

As for organic: It's good that there is no pesticides and whatnot that farmers like to put to make the veges nice, leafy and green. However, this means that there will be more insects and stuff hidden in your vege. Last time I bought an organic cabbage to make coleslaw. I cut it in half and hidden between all the leaves were like many many small black insects! Me and my wife had a nice time cutting the cabbage up.

So my advice is, raw vegetables in salads etc are good! But if you're going for an organic source, please ensure that its properly washed first and cleared of all insects. Lastly, use french salad dressing for your salad: yum.

Any dietitians out there? I'm not really a subject expert on this topic.

This post has been edited by aeternalis: Sep 13 2011, 10:28 AM

good luck aeternalis.....

btw... I have slipped disc.... any surgeons here?

THIS IS SUCH A GREAT THREAD!! THE BEST I FOUND IN LYN AFTER SO MANY YEARS OF LYN BROWSING! FINALLY SAW SOME PPL WHO IS REALLY HELPING OTHER/ I HOPE THIS THREAD CAN LIVE FOREVER!

anyway, i posted a thread before i saw this.

i got Rashes and itchy skin right above my anus. when i see in mirrow, i can see dry skin and feel some small pump maybe due to the rashes.
another problem is dry skin on lips for very long time.
i am not sure whether any dermatologist here but hope some doctor can help me.

Or optional request , if you can also recommend a good doctor for skin problem with REASONABLE price near PJ or kl area? something like around 50-100.

Thanks! We hope to be able to help...

rashes and itchy skin? Dry, chapped lips? How long you've been having this? Also, how much water do you drink each day? Are you taking any medications for any condition (e.g. acne)? Sometimes the side effects of such medications can reduce skin hydration. Also could be a allergic reaction.

Another factor could be hygiene, especially near these private areas... Maybe never change underwear too long (due to long working hours) or hard to reach during bathing. Difficult to say, but if you can take a picture of the rash and post here might be helpful for us.

Hopefully, we'll get a skin expert to comment here...

But, if it's giving really giving your problems, you really should see a doctor. Have you seen a normal GP about this? maybe some creams might help, may not need to see specialist yet? Some Calamine lotion may be able to reduce your itchiness.

Not sure about your skin condition..but maybe you can pay a visit to this doctor :

My sibling and I were former patients. Hope this helps. All the best in your recovery.

Koh Skin Specialist (Uptown)

KOH SKIN SPECIALIST
5, JLN SS21/1A
Damansara Utama
47400 Petaling Jaya
Tel: 03-77258437

Designation: Pharmacist
Area of specialisation: cytotoxic drug (chemotherapy), parenteral nutrition, extemporaneous preparation

Dr. Koh's clinic is very popular... A lot of high profile and celebrities go to him. I used to be his patient as well. However, I don't think his charges is between 50-100. It's probably more.

thank you very much.
i used to have dry lips last time when not taking enough water. but it's nothing like this. it's like a whole layer of dry skin on my upper lip. i tried to apply some vaseline, it helps but it cannot cure. everytime i stop, it will come back. so, i have to apply it like everyday. i have this for about 1 year already. but i never consult any doctor.

as for the private part. sorry, i cannot post a photo here anyway, talking about my working hours.. hmm.. ya, sometimes i work more than 12 hours a day. but just office work. although sometime after come home, i will take another 3-4 hours before bath. but surely i will take bath every morning and night and quite thoroughly (at least after i have this symptom ) and surely i will change underwear. I don't have any medication with me as of now. So, sometimes i even apply vaseline for this problem. i don't know if it helps.

talking about GP. i haven't see any doctor yet. Because nowadays, i don't know what is the capability of a GP anymore. are they good at anything? or just fever and simply give medicine. sometime don't know whether to trust them or not. too bad and specialist always came into my mind automatically. but problem is specialist is expensive and not guarantee to be good. Maybe i was wrong and thinking too much. Maybe as you said, i should consult a GP instead. i really don't know what kind of sickness they can diagnose?

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Added on September 14, 2011, 11:39 pmya, i saw he is in some high position in Malaysia dermatologist association, something like that

This post has been edited by loanneeded: Sep 14 2011, 11:39 PM

For the upper lip, try putting before sleep as well. Or you can try those with analgesics to ease the pain. Btw for the past 1 year, have you changed your working environment? You can also visit your nearest dentist to have it checked.

For your anus, is it tinea cruris? Google the picture and compare and let us know

how to check what food im allergic to? my face keep getting rashes on off.

Maybe try this?

http://www.hsc.com.my/eng/food-intolerance.php

If I want to make my teeth straight, how much will it cost? I don't want to wear braces. Looks ugly.

Also, if want to clean the teeth make it whiter, how much?

If you want straight teeth, the most reasonable solution is to wear bracers. You will look "uglier" for a couple of years, but it's better than "ugly" for your lifetime.

Tooth bleaching, in office. Probably around RM1000+.

And after that, an oral food challenge test.

I'm not a health professional, but..

Nowadays, there are invisible braces.

not invisible.. just a more transparent ... some are colourful...

http://www.invisalign.com/Why-Invisalign/Pages/Default.aspx

hey klifex! Thanks for posting up here again... Could i get your details as in which area of healthcare you working in so i can put on my first post, please?

Anyways, just wanted to report to you guys that I'm going to do ACL reconstruction on my right knee at Penang GH this Tuesday... Will be on leave for at least 6 weeks to 3 months. So probably, I'll be more active on this thread. Wish me luck guys! Haha, come visit me if you're in the area.

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Added on September 17, 2011, 5:20 amMay I ask a few questions:

Do you have asthma? or frequently have runny nose or eczema? The rash mainly on the face only is it? Can you describe the rash? Better still, can you take a picture of the rash? Will you get the rash only after you eat certain foods? What kind of foods usually trigger these rashes? How old are you, are you male or female?

Sorry so many questions.

This post has been edited by aeternalis: Sep 17 2011, 05:20 AM

invisalign has it's limitation... it is not suitable for majority of cases unless pt don't seek perfection....

I think there are other brands too if I'm not mistaken that would be quite "invisible" yet does the job?

Right ACL reconstruction Total Cost:

RM 5140 for implants

RM 9500 for allograft (an allograft is a fresh sample frozen from a dead guy, note the price is already discounted cos i'm a doctor/government servant). Maybe it's the ligament of some pretty girl. hmmm...

= RM 14640!!!

Anyone willing to sponsor me?

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Added on September 22, 2011, 9:24 amnoone want to sponsor? so sad... anyways, I've successfully completed my right ACL reconstruction and discharged home already.

All i can say is... PAIN! now on crutches, hobbling along slowly. doing self-physiotherapy at home.

Anyone who wants to know what happens during operations or how to prepare yourself before going for an operation, please post here!

This post has been edited by aeternalis: Sep 22 2011, 09:24 AM

How about lingual braces? My sister is doing lingual braces at Dr Reuben How's clinic in Berjaya Times Square. Can't see it at all. I see a lot of korean staff at the clinic... Is Dr Reuben Malaysian or Korean?

Malaysian... trained in Aussie....... lingual braces is very challenging for the orthodontist to place and make adjustments.... hence the premium price tag.....

Wahhhhh so good to have a team of doctors online
You guys are great making time to post here and help others when you are so busy whether you're a student or already practising.

At least I know where to turn to for advice should I need it.

Keep up the fantastic work

Hi,

Nowadays I easily lost concentration at work. I'm currently working in the IT industry and need to face the laptop for long hours but I easily can't concentrate and lost focus followed by headache (left side of the head) and head become like heavy...maybe this is caused by my stressful work previously...nowadays, i need to frequently take a break from my work like every 1 hour coz if I continue to force myself to focus, I'll become dizzy...

Can anyone here advise what's wrong with me? this prob has been bugging me for 2 years...thx

^
Recommend seeing a doctor. There is a also a likelihood of eye involvement, so inform your doctor for a referral to an opthalmologist.
Or you could cut the middleman and go see an optometrist. However, if headaches and dizziness are severe, doctor first.

This post has been edited by trencher10: Oct 17 2011, 12:26 PM

Hi all, i would like to find out the cost for an MRI scan at private hospitals, i read that the cheapest is Tung Shin hospital?
How about government hospitals? My gf needs to get a scan, and her mother is a government servant. Does it help?

I'm worried that the waiting list is too long..

Hello bkfeng89,

Sorry for the late reply,
Cost of MRI scan at private hospitals I believe is around RM800+ but varies with different hospitals and different views of MRI. Government hospitals you'll need to go through the process of seeing the primary discipline for the illness first (like go to Orthopaedics clinic or Surgical Clinic) and get their order to do a MRI. Then, a date for the MRI will be given but you are correct, the waiting list can be very long: Usually months.

If you want a more precise pricing, just let me know where you plan to bring your gf to (private hospital) and I'll call them up to enquire for you... I'll also need the nature of her problem and the site for MRI. Spine, i suppose?

Her mother being a government servant would be helpful. But it's even better if any of your relatives are medical personnel: then maybe can speed up the government hospital way. Govt is free. Hope this helps.

Hi, is anyone know what supplement is good for articular? My mom pain due to lack of collagen at cartilage...is calcium magnesium and omega 3 help?

Hey irene... pain in the which joints? Knee or Elbows, fingers etc? Also, how old is she?

As for the pain due to lack of collagen, how did you and her come to that conclusion?

There are many reasons for joint pains, such as osteoarthritis, rheumatoid arthritis etc...

Supplements can be helpful but do not work for some of these diseases. Can you tell me more about her problem? Maybe a visit to the orthopaedics doctor can be helpful as well

Hi aeternalis, my mom is 56 yrs old, she join pain at knee...I juz find out that I misunderstand on collagen and cartilage...and I heard tht magnesium and omega does help on tht...izit correct?