General Medical issues thread

[Pushka]

So my brother in law who moved back from the UK went to our local doctors. They don’t have Medicare yet.
Consult was $155.
Then had to go for a fasting blood test, about 6 itests listed (which usually is free for us). It cost $355!
We are very lucky to have Medicare, I know a lot of complaints about Medicare rebates, but the alternative is a lot of money.

The Medicare rebate is $41.20. My last GP was $92.57 (last week) and received that $41.20 back.

 

[RooFlyer]

Definitely risk from anaesthetic/surgery unless hernia is incarcerated (stuck)

Tell me about bloody , bilateral open hernia operation. I was the opposite of above. Had lost 20+kg, had kept it off for over a year, new lifestyle etc etc. Then developed hernias both sides.

Hernia operation was one of the 5% 'oops, we don't know why you have continuing pain/discomfort'. Couldn't exercise for 6 months, then on-and-off for another 4 months, pretty miserable, ate .... Put the 20kg back on and totally pi**ed off. When the surgeon gave the standard "x% ops will have problems", I though - OK, can accept that risk, just another op to correct. But no. No fix.

Got a second opinion, said he would have done keyhole but no fix to problems now. Fortunately after 14 months its almost gone away, but sometimes just reminds me its there.

Recent operation for arthritis in great toe main joint was also unsuccessful; went in after x-ray showed just a few minor bony growths, no worries. Came out with more pain than I went in with. Again, getting better verrrry slowly after about 3 months and an MRI, but now I can't even walk more than a km without pain developing. Getting second opinion before even contemplating facing great toe fusion.

Have lost faith in all surgeons, except my ophthalmologist. Not necessarily skill (although yes, that with my first hernia guy for reasons not gone into above) but just what they say about recovery times, benefits, risks and of problems then what follows next.

 

[Pushka]

Recent operation for arthritis in great toe main joint was also unsuccessful; went in after x-ray showed just a few minor bony growths, no worries. Came out with more pain than I went in with. Again, getting better verrrry slowly after about 3 months and an MRI, but now I can't even walk more than a km without pain developing. Getting second opinion before even contemplating facing great toe fusion.

This is why I dont want any surgery on arthritis in my big toe. Although I've noticed since being on steroi_s it's not bothering me so much anymore.

 

[RooFlyer]

This is why I dont want any surgery on arthritis in my big toe. Although I've noticed since being on steroi_s it's not bothering me so much anymore.

Mine was a cheilectomy - 'simple' removal of bony growth as shown in an x-ray. After the operation which made things worse, I was sent for an MRI, which discovered much more arthritis in that toe than the x-ray showed ( apparently - ).

Had a ultrasound guided steroi_ injection but the relief was only for less than a week. But I think it's getting better. Have some hefty anti-inflammatories and prodiene max for days where I'm going to have to walk a lot.

I've just got to hang on until mid December when I go on my Antarctica cruise, (hopefully till the end of it!!).

 

[TheRealTMA]

This is why I dont want any surgery on arthritis in my big toe. Although I've noticed since being on steroi_s it's not bothering me so much anymore.

It’s not gout is it? Uric acid levels?

 

[RooFlyer]

It’s not gout is it? Uric acid levels?

No, checked that.

Edit: sorry, you were addressing Pushka

 

[Pushka]

It’s not gout is it? Uric acid levels?

Not gout. Severe arthritis so much so I can't flex my toe. Confirmed by X-rays.

 

[TheRealTMA]

Not gout. Severe arthritis so much so I can't flex my toe. Confirmed by X-rays.

Gout is a form of arthritis especially in big toe.

 

[Pushka]

Gout is a form of arthritis especially in big toe.

Osteo. Bone on bone. I've had the same pain for maybe 10 years now. Spur? I was just told that it would keep deteriorating especially if I did a lot of weight bearing exercises, which I was doing at the time. Planks and so on.

 

[JohnK]

If you have health insurance google "Healthy Weight for Life" it's a free (assuming you have had insurance for 12 months) 12 or 18 week program that is there to help people lose weight before surgery or to reduce stress on joints if have arthritis.and a BMI above 28.

Thanks. Looks similar to the CSIRO Total Wellbeing diet. I was offered free membership to that one about 18 months ago.

I'm sceptical of any diet plan that includes an exercise plan. Let's forget exercise. This body cannot sustain exercise. I struggle to walk.

When I had chicken pox in 2010 I went from 123kg to 104 kg in a few weeks. When I met my wife in 2013 I was 115kg and when wife was pregnant in 2016 I was back at 123kg.

In April that year I started my own 1200-1500 calorie a day diet. I wanted to look good for my daughter's birth. By August 2016 I was down to 108kg. Looked good. Felt good.

My daughter was born early September. By November I had 7 trips back and forth to Thailand. Weight up to 115kg again and by 2020 weight had reached 132kg. Nothing I tried worked. Body won't let any diet work.

We came back from Thailand in March 2020 and wife and I started new diet and walking each night through the lockdowns. Wife lost 15kg easily. I lost 8-10kg but not easy to maintain. In April 2021 I could not walk anymore. Weight ballooned to 145kg and I've been 135kg-145kg since.

Notice a pattern? Diets are not easy. Weight increases past starting weight of previous diet each time. I'm now 140kg as I forced myself to walk through the pain from May 2022. I need to try a new diet. I need to try and trick the body. Eat normal for breakfast and lunch and then just have salad and vegetables for dinner.

 

[OZDUCK]

Mine was a cheilectomy - 'simple' removal of bony growth as shown in an x-ray. After the operation which made things worse, I was sent for an MRI, which discovered much more arthritis in that toe than the x-ray showed ( apparently - ).

Had a ultrasound guided steroi_ injection but the relief was only for less than a week. But I think it's getting better. Have some hefty anti-inflammatories and prodiene max for days where I'm going to have to walk a lot.

I've just got to hang on until mid December when I go on my Antarctica cruise, (hopefully till the end of it!!).

While you are in Antarctica you could go barefoot for a while and remove the problem toe entirely.

 

[cove]

I start outpatients physio at the beginning of November to get my Knee replacement working properly. Haven’t had to do so much pain killers ever so I hope it settles down next week. The surgeon pulled out a cup full of debris so that explained why my knee locked up A few weeks ago.
We are flying to Sydney and Los Angeles from Perth starting just before New Year.

 

[Pushka]

I start outpatients physio at the beginning of November to get my Knee replacement working properly. Haven’t had to do so much pain killers ever so I hope it settles down next week. The surgeon pulled out a cup full of debris so that explained why my knee locked up A few weeks ago.
We are flying to Sydney and Los Angeles from Perth starting just before New Year.

The trick with knee replacements it seems, is to really focus on doing the physio as required. Not skimp on it.

 

[Lynda2475]

Thanks. Looks similar to the CSIRO Total Wellbeing diet. I was offered free membership to that one about 18 months ago.

It's different in that is supervised by medical professionals and they give you free vlcd protein shakes to get the weight moving.

I'm sceptical of any diet plan that includes an exercise plan. Let's forget exercise. This body cannot sustain exercise. I struggle to walk.

The exercises are physio style for those with arthritis not a work out. designed to help with mobility.

Anyway only mentioned it because my friends Mum had great success with it ahead of her hip replacement.

 

[Quickstatus]

Have lost faith in all surgeons

Which is why it's so important to
1) optimise pre operative condition to minimise operative risks (@JohnK)
2) define the goals of the surgery . With any surgery, resolution of pain is not necessarily a guaranteed outcome (@RooFlyer).

Chronic pain post hernia surgery

Had a pt last week - came in with abdominal pain, she had appendix removed 2 weeks ago. Still has pain. "BBbut Dr said pain is from appendix".

The trick with knee replacemenus it seems, is to really focus on doing the physio as required. Not skimp on it.

In fact with most surgery with some exceptions, early mobilisation is important. "It's not a hotel....." Got to Eat/Poo/Walk

 

[Lynda2475]

The trick with knee replacements it seems, is to really focus on doing the physio as required. Not skimp on it.

When my Dad had knee replacement physio started day after the operation. He went to a live in rehab centre straight from hospital, they have you walking day after operation and you stay for 2 weeks with physio 3 times a day so you go home being able to climb stairs then do outpatient physio twice a week for another 8 weeks to make sure you keep up the exercises. Hydro therapy included.

Having seen the success I wouldn't agree to any other style of rehabbing plan. Noting the lady in the next room refused to do the exercises and ended up with very limited range of movement.

 

[Quickstatus]

ent physio started day after the operation

Day of surgery over here and increasingly prior to surgery "Prehab" - which is what @RooFlyer did

rehabbing

The health funds are clamping down on unrestricted post joint replacement rehab

 

[Lynda2475]

Day of surgery over here

Depends what time surgery was done. They were running late, so physio had gone by 9pm when he was brought to room from recovery. So quick assessment next morning before transfer to rehab centre.

The health funds are clamping down on unrestricted post joint replacement rehab

Where did I say unrestricted? The two weeks live in rehab were fully covered by bupa (accomodation, meals, physio, hydro all onsite) then outpatient was 16 visits (8 weeks of biweekly) at same centre.

After that back to the usual annual limits of 12 visits, although not needed.

Of course depends on quality of health insurance policy you have, and conditions at home, my parents have stairs so doing rehab at home not an option, as no full bathroom on ground floor.

 

[Quickstatus]

@Lynda2475
No criticism of what you wrote

Your example of late surgery and next morning physio is within the first 24hrs post op. So the early ones get afternoon physio day of surgery. Late finish ones get it first thing the next morning. The nurses actually help pt get up ASAP.

Re unrestricted rehab: this is happening now. They are clamping down on it unfortunately
While the example you gave is excellent, the reality is that it is becoming harder to get a patient into rehab even with top of the line PHI.

 

[tgh]

it is becoming harder to get a patient into rehab even with top of the line PHI.
This makes no sense at all…….. why make more folks sicker later to save a buck?
Lots of anecdotal experience.. physio works as long as the patient works...