General Medical issues thread

[Quickstatus]

This drug has been a game changer for many people (with and without diabetes).

I'm cautioning people re GLP1 drugs like above. There are reports of seriousgastric problems coming out - primarily problems with gastric emptying (gastroparesis)

 

[MARTINE]

I'm cautioning people re GLP1 drugs like above. There are reports of seriousgastric problems coming out - primarily problems with gastric emptying (gastroparesis)

I still think a detailed assessment with an endocrinologist to individualize the risks and benefits with a plan is a good approach. I think it’s a long term process and not for everyone but worth being fully informed in the decision making. The GI side effects are not universal or always long term and complications of obesity can be worse.

 

[Quickstatus]

The GI side effects are not universal or always long term

I'm increasingly thinking that there is a small group where gastroparesis has persisted despite stopping it. I've seen one but n=1 is not exactly strong evidence.

 

[RooFlyer]

You could look at the newer drugs Mounjaro

I’ve just started this after having tried Ozempic which did absolutely nothing on the appetite front. As you worked know, costs though.

GP and cardiologist both on board.

 

[prozac]

How do I get some food poisoning? I was 144.7kg earlier this week. The highest I've ever been. I'm really struggling to walk and pain everywhere even when I stand up.

General surgery outpatients junior doctor asked if can do exercise. You're kidding right? How about if we get you appointment with dietician. OK but not sure how that's going to help.

Cellulitis is really worrying me. Have to lose weight.

Only thing I am doing differently is eating a handful of nuts with breakfast per nutritionist instructions.

Cellulitis. Rest and elevation but you already know this. Lower leg should be height of your hip. I elevate even when I do not have cellulitis. Precautionary.

@RooFlyer Nuts in the morning and snacking. Cheaper than medication

 

[Quickstatus]

Anaesthetists are unsure how long GLP1 should be stopped before an elective general anaesthetic because of the delayed gastric emptying issue. Some are saying 4 dose equivalents. Some 2. Mounjaro/ozempic is once a week so stop 2-4 weeks prior to elective surgery. Still up in the air about this one.

 

[Quickstatus]

handful of nuts

What's your favourite nut?.

I actually do Almonds

 

[MARTINE]

Anaesthetists are unsure how long GLP1 should be stopped before an elective general anaesthetic because of the delayed gastric emptying issue. Some are saying 4 dose equivalents. Some 2. Mounjaro/ozempic is once a week so stop 2-4 weeks prior to elective surgery. Still up in the air about this one.

Appreciate this is def an issue for surgery

From my reading Mounjaro (which has the extra receptor agonist activity) may be better tolerated - but it is early days.

 

[RooFlyer]

Anaesthetists are unsure how long GLP1 should be stopped before an elective general anaesthetic because of the delayed gastric emptying issue. Some are saying 4 dose equivalents. Some 2. Mounjaro/ozempic is once a week so stop 2-4 weeks prior to elective surgery. Still up in the air about this one.

I was told to stop Ozempic 3 weeks prior to cardiac ablation procedure by the electrophysiologist. I actually stopped it 4 weeks prior as it was having no effect (got to about 7th dose). Oddly, the anaesthetist didn't quiz me about it at all; maybe they actually read the paperwork I submitted.

 

[prozac]

What's your favourite nut?.

I actually do Almonds

I like Brazil nuts. As I was told mixed nuts I have a few of everything, almonds, walnuts, cashews. I only have one or two Brazil nuts daily as nutritionist says they contain something that is coughulative and should be eaten sparingly.

 

[Quickstatus]

- but it is early days.

Very early days and the demand is huge.

I'm finding some people are not disclosing they are taking GLP1 unless specifically asked. I understand the stigma. An anaesthetic colleague said one patient disclosed ozempic the day of surgery. Needless to say his op was cancelled.

 

[Quickstatus]

maybe they actually read the paperwork I submitted.

With the advent of online history submission, there is less need to rehash orally your medical story .

Also less issues with remembering names of pills:
Q:What pills do you take for your Blood pressure
A: I don't remember the name but It's a blue pill

 

[RooFlyer]

With the advent of online history submission, there is less need to rehash your medical story .

Oh, it still has to be re-hashed a couple of times 'tween admission and procedure (Healthscope). Some things, sure, double checking, but others "have you read my admission record?"

 

[Quickstatus]

double checking

They Should be using it to tease out the details

 

[TheRealTMA]

What's your favourite nut?.

I actually do Almonds

Do you activate them first?

 

[Quickstatus]

Do you activate them first?

Too much work rinsing soaking heating.
Similar reason why I don't drink coffee - too much effort

 

[RB001]

I like Brazil nuts. As I was told mixed nuts I have a few of everything, almonds, walnuts, cashews. I only have one or two Brazil nuts daily as nutritionist says they contain something that is coughulative and should be eaten sparingly.

Selenium, I believe.

 

[JohnK]

Have to lose weight

I have told you many times already.. you are what you eat and you feed yourself too much.
Just like an alcoholic.. you must accept your personal reality.. only you can help yourself.
Minimal calorie intake, exercise.. exercise exercise
Walk through the pain, in this context pain is your friend.. only allow minimal nsaids for recovery.
You already know the alternative…...

Thanks for the advice bit I'm not sure you've considered all the facts.

Walking with a limp and holding my lower back and stopping regularly achieves nothing. Medicine does little for my pain. I also have to work 7-8 hours a day. I have to take daughter to school and pick her up, I take wife to work. I do the shopping. When do I find the time to exercise? Morning? If I exercise in the morning I can't do anything for the rest of the day because I'll be exhausted.

It's not always about eating. I've been having 2 lettuce salads a day. You do realise it's possible to not eat and put on weight? This time 9 years ago I was counting calories. I still have the Excel spreadsheets. Anything over 1800 calories a day and no weight loss. For any significant weight loss had to be less than 1500 calories a day. I did that for 5 months. That was the last successful weight loss. I cannot do that today.