Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
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Dear Martin,
I already asked a question last week about the pain in my hips with a corresponding hospital report. Your advice was to have an X-ray taken. I went to a doctor in a private clinic, he took these pictures (sent them as an attachment) and told me that I could no longer be cured. My liver and heart were also not good according to him.
All in all, it came down to this, that I was written off. I find it a bit intimidating, I don't feel that bad.
Your advice please.
Many thanks in advance.
Regards,
Hans
****
Dear h,
Don't be too pessimistic.
To start with the hips. There is a slight osteoarthritis of both hips. A transverse photo (lateral view), to make a better diagnosis, is missing. That can indeed hurt, but I think the pain is mainly coming from your back, which shows a severe scoliosis (sideways curve). There's not much you can do about that at your age. A photo of the whole back will undoubtedly also show neck problems.
The picture of your heart doesn't say much. The aorta shows a moderately large arc, which could indicate a high blood pressure for many years. It may also be related to the scoliosis.
Your heart is slightly enlarged, but that doesn't mean it's not right. He may prescribe a diuretic (“water tablet”) for you. Personally, I would give Spironolactone 12,5 or 25mg, or Chlorthalidon 25 or 50mg, before breakfast. Cheap old resources, which are still among the best. The newer drugs generally have no advantage, but are much more expensive and often have more side effects.
The few liver values in the blood test are excellent. Cholesterol is slightly elevated, but no reason to treat.
I don't understand how the doctor arrives at his opinion with so little information. Rather, it seems that he sees that your back is almost untreatable and that is why he pulls his hands off it.
Based on the information you've sent me, I'm not too concerned. That doesn't mean, of course, that nothing is going on.
My advice is the following. To be on the safe side, have your heart checked and see a well-trained physiotherapist. He will give you exercises for your back. Surgery on your hips will probably end in disappointment.
Hard Thai massage is excluded here and can even be dangerous.
Take painkillers if necessary. Otherwise, if you are indeed healthy, you may have many good years and, as I used to say, "Where there is pain, there is life." A small consolation, of course.
If you have any further questions, please let us know.
Yours faithfully,
Dr. Maarten