General Medical issues thread

[cove]

My cardiologist would weigh 60 kgs provided he is wearing boots. I come away thinking about all the naughty foods he is missing out on.

 

[prozac]

My cardiologist would weigh 60 kgs provided he is wearing boots. I come away thinking about all the naughty foods he is missing out on.

Sounds like we use the same fella. Mine also rides a road bike. I reckon he would be safer eating carbohydrates.

 

[Katie]

Dad's in recovery after his TURP, apparently it went well.

Mum just texted (Mum and Dad have not been married to one another since the 70s); my 98yo Grandma fell on her way to lunch, just in the doorway of her room. The RN at her home is looking after her, G'ma didn't hit her head, but landed on her knee, which will probably be rather sore.

 

[Katie]

The Sestamibi heart scan and other investigations is only to determine medical suitability for surgery and anaesthetic.

Surgery only puts a new knee joint in, but the outcome of a TKR is not that a new joint is put in. It is what happens to the knee function after a new knee joint is put in. When a knee deteriorates, the muscles that move the knee get used less so they atrophy. Once a new knee is put in the muscles don't magically go back to normal. Anything that can be done to improve the muscles before hand only improves the TKR outcomes.

It is also well known that High BMI is associated with poorer outcomes after a TKR.
Its hard enough to be back on your feet the day of or day after a TKR (which is the immediate goal after a TKR) let alone while carrying extra 40-50kg on your back doing so.

Therefore "Prehab" is as important as Rehab.
Outcomes can be quite positive and life changing but there is a lot to do between now and March to get there. At least there is some time.
Father needs to get his leg muscles as strong as possible and optimise his medical issues, lose weight prior to surgery in order to gain the best outcome possible.

Which is sad because it is the most effective way of getting a better result from surgery. In fact in some cases the outcome is surgery is no longer needed.

When angioplasty was first done stents had not been invented and it was balloon angioplasty. In 1992 I had the privilege of looking after the first ever proceedure done in 1962 at St. Vincents hospital Sydney in 1962. He obviously survived and had no cardiac events since. He had a negative sestamibi test. his Cardiologist though had died.

I understand, I'm just not sure how I can broach it in a way that would be received well, and more crucially, result in action. Dad already has a skinny wife telling him to eat less, etc. Nagging or lecturing won't help.

I'm sure his surgeons must have broached it with him. He does not enjoy being the size he is, and the limitations it brings. It doesn't help other aspects of his health.
From a discussion a sibling has relayed to me, I think there's big issues of self esteem (he doesn't want to fail - again). How do you gently encourage your Dad to give it a try without him feeling like he'll disappoint his family if he fails?

He had managed to find a supportive gym and trainer and was starting to get into fitness activities earlier this year; I just can't remember when this knee injury occurred.

 

[Quickstatus]

If the required course was in the one box, why does the script have a repeat?

Possibly a convenience thing, if the problem is not sorted with the first course?

Post automatically merged: Friday at 2:02 PM

How do you gently encourage your Dad to give it a try without him feeling like he'll disappoint his family if he fails?

It's very hard. Sometimes discussions in family environment can be too confronting.
Maybe his GP?

 

[tgh]

BBBut Pushka.. you do manage your fate , otherwise you would probably not be here...
Mastery of fate does not imply mastering the universe.. just managing the dealt cards well enough to live as long and as well as possible.

 

[Pushka]

BBBut Pushka.. you do manage your fate , otherwise you would probably not be here...
Mastery of fate does not imply mastering the universe.. just managing the dealt cards well enough to live as long and as well as possible.

Ok. I'll buy that. . I am in control. Unless I forget or think I can do without my pred tablets for the day.

Today I had a skin cancer check. I never sunbathed as a kid as I hated th feel of the sun on my skin. No one really knew much about skin cancer in those days and what the heck was sunburn cream? Most used coconut oil or something. Zoom forward to my forties and my UK fair skinned father was a patchwork of skin grafts and lost his left ear due to multiple skin cancers. Stupid naval peak hats the Navy made them wear on ships. Anyway. I just have a few skin drying areas on my forehead - weird as I have always had a fringe as I hate my forehead and they were burnt off (ouch) which another check in May to see if they are gone. But nothing on my shoulders, chest or back. Dr said it showed I never sunbaked as a kid. MrP had a couple of pre cancers removed today as well, and we will both show our scars to our grandkids on Sunday as a reminder why Mummy and Daddy put on sunburn cream. Scars aren't at all graphic but enough to make the kids listen.

And another thing with steroi_s. Makes you more prone to sun cancer. For such a wonder drug it's a wicked drug.

 

[JohnK]

John I heard that many times over my career. As a mentor of mine once said The commonest cause of obesity is caloric amnesia.
Sorry I see your pictures on here about your bargain buys plus the pictures of them cooked. They certainly don't look like 1-2 salads a day.
One problem is in Australia the cheaper the meat the higher the fat content so the higher
the caloric intake.

Lucky you didn't see what I bought yesterday. $33.92 on markdowns only. These are not low quality. These are normal packs of meat that were selling for 10x the price the day before.

If I am not mistaken adult males need to consume somewhere between 26.4 to 39.5 calories per kg of weight per day. The lower number is no exercise and the higher number is an active person.

I am 140kg which means for me to maintain that weight with no exercise I need to consume 3700 calories day. I can assure you I am nowhere near 3700 calories per day. So what is the problem? I wish I knew.

Today is a typical day for me

- morning kids yoghurt pouch around 75 calories
- lunch a big bowl of iceberg lettuce with light mayonnaise which I estimate to be around 100 calories
- dinner 2 small pieces of boiled chicken (ribs and back), masaman curry paste, equivalent to 2 medium potatoes, portion of coconut milk, steamed rice (let's say 1000 calories but it was nowhere near it)
- snack 1 piece sliced bread with around 50g ham which I estimate around 150 calories

That's it for today. So around 1325 calories today. That is a long way short of 3700 calories?

I did some exercise. I walked 700m or so to the office. I walked back 2 hours later. The walk back was torture. Pain everywhere in lower body. This body is done. Cannot be repaired. Oh and I just walked up 30 steps with 9kg in each hand. My knees were about to give way.

Life is a struggle. I'll keep trying to lose weight. So far I've lost ~1.5kgs in 3 weeks. Not easy. We'll be in Thailand for 4 weeks which will make it even harder.

 

[Flashback]

Lucky you didn't see what I bought yesterday. $33.92 on markdowns only. These are not low quality. These are normal packs of meat that were selling for 10x the price the day before.

If I am not mistaken adult males need to consume somewhere between 26.4 to 39.5 calories per kg of weight per day. The lower number is no exercise and the higher number is an active person.

I am 140kg which means for me to maintain that weight with no exercise I need to consume 3700 calories day. I can assure you I am nowhere near 3700 calories per day. So what is the problem? I wish I knew.

Today is a typical day for me

- morning kids yoghurt pouch around 75 calories
- lunch a big bowl of iceberg lettuce with light mayonnaise which I estimate to be around 100 calories
- dinner 2 small pieces of boiled chicken (ribs and back), masaman curry paste, equivalent to 2 medium potatoes, portion of coconut milk, steamed rice (let's say 1000 calories but it was nowhere near it)
- snack 1 piece sliced bread with around 50g ham which I estimate around 150 calories

That's it for today. So around 1325 calories today. That is a long way short of 3700 calories?

I did some exercise. I walked 700m or so to the office. I walked back 2 hours later. The walk back was torture. Pain everywhere in lower body. This body is done. Cannot be repaired. Oh and I just walked up 30 steps with 9kg in each hand. My knees were about to give way.

Life is a struggle. I'll keep trying to lose weight. So far I've lost ~1.5kgs in 3 weeks. Not easy. We'll be in Thailand for 4 weeks which will make it even harder.

Processed meats and hidden sugar are the things I spot in the list above, that makes some difference.

That pain doesn't sound like much fun at all!

 

[Quickstatus]

I am 140kg which means for me to maintain that weight with no exercise I need to consume 3700 calories day

Does not sound right

What is your height and age - can DM if you like. I'll calculate for you

But using generic numbers:
140kg
1.75m
60years
Male

Using the Harris Benedict formula for basal metabolic rate (of which there are several variations)
For males: (9.65xweight)+(573xheight)-(5.08*age)+260
For females: (7.38xweight)+(607xheight)-(2.31xage)+43

There are other equations for BMR such as Mifflin-St Jeor, Katch-McArdle

BMR = 1788 calories

Then use activity multipliers
Sedentary no/little excercise 1.2
Light exercise 1-3x/week 1.37
Moderate exercise 3-5x/week 1.55
Hard exercise 6-7/week 1.725

The H-B equaion include sports in all exercise multiplier
If no sports then multiplier is likely between 1.2 and 1.37

Using light exercise 1788x1.37 = 2450 calories/day

No one should consume less than their BMR - this is actually bad.


Lets use a step/calorie estimation which is based on height and weight

for 140kg 1.75m
10000 steps = 745 calories
5000 steps = 373 calorie
3000 steps = 250 calorie

 

[prozac]

Processed meats and hidden sugar are the things I spot in the list above, that makes some difference.

That pain doesn't sound like much fun at all!

@Flashback I only see one small portion (50g ham) processed meat, the rest is chicken. The kids yoghurt pouch is full of bad stuff and could be replaced by say Aldi Natural Greek Yoghurt with natural (not toasted) meusli on top or replaced with natural rolled oats. This was my b'fast today.

I have this suspicion if we have weight issues we should eat what we are genetically programed for. If you are Greek then that would be a Greek style diet, German, then a traditional German style diet, Spanish, etc..

 

[Quickstatus]

If you are Greek then that would be a Greek style diet

Well thats what the Japanese say - their diet has traditionally included whale....

 

[prozac]

Well thats what the Japanese say - their diet has traditionally included whale....

Only since they had the technology to build whale chase boats.

 

[Quickstatus]

technology to build whale chase boats.

Which have existed in Japan for hundreds of years. Genetically though 800 years is less than a blink on the evolutionary scale

 

[prozac]

Lucky you didn't see what I bought yesterday. $33.92 on markdowns only. These are not low quality. These are normal packs of meat that were selling for 10x the price the day before.

If I am not mistaken adult males need to consume somewhere between 26.4 to 39.5 calories per kg of weight per day. The lower number is no exercise and the higher number is an active person.

I am 140kg which means for me to maintain that weight with no exercise I need to consume 3700 calories day. I can assure you I am nowhere near 3700 calories per day. So what is the problem? I wish I knew.

Today is a typical day for me

- morning kids yoghurt pouch around 75 calories
- lunch a big bowl of iceberg lettuce with light mayonnaise which I estimate to be around 100 calories
- dinner 2 small pieces of boiled chicken (ribs and back), masaman curry paste, equivalent to 2 medium potatoes, portion of coconut milk, steamed rice (let's say 1000 calories but it was nowhere near it)
- snack 1 piece sliced bread with around 50g ham which I estimate around 150 calories

That's it for today. So around 1325 calories today. That is a long way short of 3700 calories?

I did some exercise. I walked 700m or so to the office. I walked back 2 hours later. The walk back was torture. Pain everywhere in lower body. This body is done. Cannot be repaired. Oh and I just walked up 30 steps with 9kg in each hand. My knees were about to give way.

Life is a struggle. I'll keep trying to lose weight. So far I've lost ~1.5kgs in 3 weeks. Not easy. We'll be in Thailand for 4 weeks which will make it even harder.

Well done on the weight loss John. I am seeing a Nutritionist in January (after Christmas). I have been told that you can ask your GP for some type of nutritionist recommendation that will reduce the cost by $60.

 

[TheRealTMA]

Well thats what the Japanese say - their diet has traditionally included whale....

A furfy actually.

"Japan may have a long and storied history of whaling dating back to the Edo period in the 1600s, but experts say whale meat consumption only really peaked after World War II – when food sources, especially protein, were scarce."

 

[JohnK]

Processed meats and hidden sugar are the things I spot in the list above, that makes some difference.

That pain doesn't sound like much fun at all!

Before my daughter was born in 2016 I saw 2 nutritionists at Princess Alexandra hospital. Ham was part of my diet. Ham is filling and not high in calories. I am not concerned about processed meats or hidden sugar. 100g of Ham is 160 calories. There can't be that much sugar in 160 calories of Ham. By the way I was not eating bread and the nutrionists asked me to eat bread each day. I lost ~15kg in 5 months.

@Quickstatus I was 173cm. Think I've shrunk a little and continue to shrink. Very little exercise if any. Any exercise is only walking inside shopping centre 2-3 days a week.

@prozac I've been seeing general surgery outpatients at Royal Brisbane for the hernia. They have offered free nutrionist to help me lose weight. The only reason I don't go for nutritionists is I do not want to be told what to eat. I've seen some of the diets and I don't want to eat that food. I want to eat what I want, what I enjoy, but keep the calories down.

 

[prozac]

MrsProzac is to see a Neurophyscologist in February. The introductory letter from the doctors rooms indicate "Neuropsychological services aren’t covered by Medicare or Private Health Insurance" Will the fee, $1950, will be added to the medicare safety net tally?

 

[MARTINE]

MrsProzac is to see a Neurophyscologist in February. The introductory letter from the doctors rooms indicate "Neuropsychological services aren’t covered by Medicare or Private Health Insurance" Will the fee, $1950, will be added to the medicare safety net tally?

No

 

[Himeno]

I got test results back on Saturday night from the urine test last week. Didn't know that the walk in center had sent it off for additional tests after they did the dip test.

Got a call from the walk in center with the results. The predominate bacteria detected (pseudomonas aeruginosa) is resistant to the antibiotic they gave me, and also appears to be resistant to the different antibiotic my GP gave me (to have something on hand if needed when I'm overseas soon) on Friday.
Trying to get another GP appointment for review of the antibiotics before I go on holiday while working around limited availability (more so at this time of year).