General Medical issues thread

[Quickstatus]

it's been around for ~6 months now.

If GP is convinced why refer to Derm?.
The answer is because its not getting better with standard treatment after 6m
>> Get biopsy.

The biopsy effectively is your 2nd opinion.....

 

[VPS]

I went to a dermatologist today for a large circular discolouration I have on my trunk. It was originally a darker skin colour, but has lightened with Eleuphrat steroi_ cream, but hasn't totally gone. Not itchy and not raised. Dermatologist didn't have an answer, and recommended a biopsy to rule out anything scary. Feels overkill, and wasn't particularly impressed with the dermatologist. My GP was fairly convinced it was dermatitis, but did recommend a dermatologist consult given it's been around for ~6 months now.

I would definitely go with the biopsy. Better overkill than the alternative

 

[Pushka]

I would definitely go with the biopsy. Better overkill than the alternative

MrP had three skin biopsies a couple of weeks ago. It was thought to be malignant. They weren't. But having them removed anyway next Friday. So far the cream has worked for the BCC I've had.

 

[prozac]

MrP had three skin biopsies a couple of weeks ago. It was thought to be malignant. They weren't. But having them removed anyway next Friday. So far the cream has worked for the BCC I've had.

A few months ago I did 4 courses of chemo cream 5-FU on my scalp. Ended up with a big ulcer or two. Dermatologist said he thought it was a cancer and took a biopsy. Negative. Now all healed and back to normal. Then I did both sides of face, 1.5 courses. When I went in for my infusions last week they commented the face looked really good. No harm getting a biopsy tested.
Have I already mentioned all of this?
Anyway, we have put the raised LDH numbers (I had progressively increasing cancer markers) down to the repeated FU treatments as LDH numbers have now settled.

 

[MARTINE]

Of course, a lot will depend on what is found, your father's age and other health factors.

As a general rule, I believe that >age 75-80 there is a reluctance to perform radical prostatectomy. It is an operation that requires 3h or more under anaesthesia.

As I understand it, older men are more likely to be treated with radiotherapy/brachytherapy or androgen deprivation therapy.

Even if he were to have a radical prostatectomy, it is only one night in hospital, then barely a week at home with a catheter. Once the catheter is removed, it might be a few days before the renal sphincter snaps back into action, necessitating thick pads. Within two weeks, life should be pretty much back to normal in terms of non-strenuous activities like walking and driving, and improving bladder control, with only light pads needed. Restoration/adjustment of sexual function is a longer game.

Obesity is not helpful for a radical prostatectomy and it is a good idea to engage in a program of pelvic floor muscle strengthening beforehand. There is a world-class specialist men's physiotherapist in Perth (PhD in prostate surgery recovery).

Taking all other clinical factors into account in determining the management of prostate cancer age is now viewed differently. A man in otherwise good health, activity levels, non-smoker with high level functional independence and -critically - ten year life expectancy would be considered for discussion of surgical treatment. This occurs even if aged 80+ . A risk benefit approach is applied. There are some 60 year old men whose poor medical status would preclude surgery/aggressive chemotherapy.

So age is now not a binary consideration.

The most important thing is a long and detailed discussion with GP and urologist. All the confusion has arisen where there has been inconsistent advice across clinical guidelines nationally and globally.

… we have excellent care for prostate cancer in Australia and imaging (MRI) has been a game changer. We have some of the best researchers and lead the world in use of PET scan.

Get the best advice possible.

Watchful watching does not equate to no action.

Remember the aim of good care is reducing risk of dying from metastatic disease (which is awful)

 

[prozac]

Taking all other clinical factors into account in determining the management of prostate cancer age is now viewed differently. A man in otherwise good health, activity levels, non-smoker with high level functional independence and -critically - ten year life expectancy would be considered for discussion of surgical treatment. This occurs even if aged 80+ . A risk benefit approach is applied. There are some 60 year old men whose poor medical status would preclude surgery/aggressive chemotherapy.

So age is now not a binary consideration.

The most important thing is a long and detailed discussion with GP and urologist. All the confusion has arisen where there has been inconsistent advice across clinical guidelines nationally and globally.

… we have excellent care for prostate cancer in Australia and imaging (MRI) has been a game changer. We have some of the best researchers and lead the world in use of PET scan.

Get the best advice possible.

Watchful watching does not equate to no action.

Remember the aim of good care is reducing risk of dying from metastatic disease (which is awful)

My cousin died of the extended effects of prostate cancer. He left it so long that when he finally went to hospital they simply removed everything "down there". He lasted about 18 months before it was too much (through bones in his legs etc) and he had himself put down.

 

[Human]

Does anyone know whether there's an official website where you can search about bringing medications into the USA? My specific question is whether I can bring a supply of Loperamide (Imodium/Gastrostop) with me for personal use when I travel there next month.

 

[prozac]

Does anyone know whether there's an official website where you can search about bringing medications into the USA? My specific question is whether I can bring a supply of Loperamide (Imodium/Gastrostop) with me for personal use when I travel there next month.

Buy it there if you are worried.
Price comparison :

https://www.goodrx.com/loperamide

 

[Human]

Buy it there if you are worried.
Price comparison :

https://www.goodrx.com/loperamide

Thanks. So it looks like it's over-the-counter in the USA, as it is here?

 

[prozac]

Thanks. So it looks like it's over-the-counter in the USA, as it is here?

I couldn't tell you for certain but the link suggests you can get it at supermarkets.

 

[Quickstatus]

Loperamide is OTC S2 medicine in same schedule category as Panadol

 

[Himeno]

Went to the walk in center this morning.
Got a migraine yesterday. It mostly cleared up last night, but got worse while walking to the bus on the way to walk.
They also confirmed the suspected UTI I've had since late last week.

9 months with an SPC and no infection, then 2 in 3 months.

Urologist is arranging a procedure (which likely won't happen until after Feb) to get in and hopefully fix the stricture and remove the SPC. If that doesn't work long term, it becomes time for surgery.

 

[prozac]

Went to the walk in center this morning.
Got a migraine yesterday. It mostly cleared up last night, but got worse while walking to the bus on the way to walk.
They also confirmed the suspected UTI I've had since late last week.

9 months with an SPC and no infection, then 2 in 3 months.

Urologist is arranging a procedure (which likely won't happen until after Feb) to get in and hopefully fix the stricture and remove the SPC. If that doesn't work long term, it becomes time for surgery.

Have you tried naprosyn for migraine? If no script you can try it out OTC as naprogesic.

 

[Katie]

Talked to my Dad last night, was slightly concerned as when I first rang, they had guests over and my step-mother commented about needing to catch me up on Dad's medical news.

Anyway, Dad's off to Club Wes on Friday for a TURP, expected to stay over the weekend and be discharged on Monday. I'm unsure of Dad's symptoms and what led to this; I was talking to Dad with the Teen there, and she gets worried about some medical matters, so I just didn't ask.

Dad is a large man, not sure, probably in the range of 150+ kgs and 6'4", so I do worry a little bit about anaesthetic (but have lots of faith in the medicos treating him, even though I don't know who they are).

He's also getting a knee replacement in March. I think this is due to an ongoing knee problem, there has been some talk about a meniscus tear, but clearly it was more serious than that. Dad and step-mother recently cruised from HNK to SYD and Dad apparently couldn't manage any of the excursions due to his inability to walk far. :/

I have no updates on my FIL and his heart failure. He seems to be getting frailer and frailer, though got a bit excited earlier this week and rang me to ask what booze his daughters drink - clearly he was feeling well enough to get to the bottlo to do his Christmas shopping!
He's disinclined to go out, so I see that as a positive sign.
He was apparently going to have cataract surgery, which was also great news after his cardio saying to cancel all planned procedures earlier this year as he wouldn't survive them.

 

[Quickstatus]

150+ kgs and 6'4"

BMI 40+
Has he had a pre- anaesthetic workup? to check all the intercurrent medical issues which may include heart, BP, diabetes, sleep apnoea?

Needs a Sestamibi heart scan at a minimum.

 

[drron]

BMI 40+
Has he had a pre- anaesthetic workup? to check all the intercurrent medical issues which may include heart, BP, diabetes, sleep apnoea?

Needs a Sestamibi heart scan at a minimum.

Plus a determined effort at weight deduction before the knee replacement.

 

[Katie]

Plus a determined effort at weight deduction before the knee replacement.

Not a topic I suspect I can broach successfully.

 

[prozac]

Just wondering if there has been any advancements in angioplasty procedures past few years. Someone suggested to me recently that arterial plaque could be physically removed. I was skeptical (very).

 

[Quickstatus]

Just wondering if there has been any advancements in angioplasty procedures past few years.

Rotational coronary arthrectomy becoming more mainstream for complex coronary disease that can't be fixed with a stent

Arthrectomy now is the main method rather than stent in leg arterial blockages

 

[prozac]

Rotational coronary arthrectomy becoming more mainstream for complex coronary disease that can't be fixed with a stent

Arthrectomy now is the main method rather than stent in leg arterial blockages

Interesting though i do not see it offered on local hospital cardiac websites.
Edit: Found one scvc.com.au