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

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.

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.

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

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.

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...

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

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.

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.

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

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

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.

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