Question to GP Maarten: Are my blood tests correct as far as the stroke is concerned?
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 am still 76 years old and have been living in Thailand since 2009. From 1999 to 2009 I was a citizen of Thailand for 8 months here and 4 months in the Netherlands.
First a little history. In 2010 I had an operation here in the Changmai Ram Hospital, for an enlarged prostate, that all turned out well. In 2013 I underwent surgery for colon cancer, also in Changmai Ram Hospital. Then undergone the necessary scans and keyhole surgery, also 12 chemotherapy with Flu 5 every 2 weeks, including 2 nights in the hospital, received 2 liters of chemotherapy at a time.
Still under the care of my oncologist. The keyhole operation is now again in 3 years, the scan again in 2 years I think. As far as my bowels are concerned, I am very satisfied with my oncologist and would therefore like to stay with her for any check-ups.
But now the next. When I was in the Netherlands last year (2018) I had a stroke there. Have been in the MCL Leeuwarden for 4 days, also 1 time for a control test. In late July 2018 I was here again and went to my oncologist again. To tell this also that I still have enough medicine until September. Then an appointment was made for new medicines, she also wants to have a scan done in September. The scan was good, received medication for 3 months. Back in December and was checked again, my blood pressure was a bit too high, 150-90 and was therefore given blood pressure lowering medication. I think instead of 3 pieces now see 4, only take the one for the morning of which I only need half.
Because I have received permission from VGZ with my ZKV in the Netherlands to get medicines for six months, reason because I can normally call my GP in the Netherlands, who will then give me a repeat prescription, they don't do that here, have to go to the doctor, in the hospital and don't feel like it.
I have to come back on 28-05-2019. Today I started counting how many medicines I have left that is 90. Now my question to you. I trust my oncologist about my colon cancer, but not about my stroke.
I plan to cancel my appointment on 28/05/2019, also because I still have enough medication until July, and also to ask her about my stroke to go to a neurologist.
Are my blood tests OK for the stroke? Didn't take the last kind of medicine. In retrospect also my mistake, should have gone straight to the neurologist when I was here again, but did not want to pass my oncologist, hoping that she would refer me to the neurologist.
For the rest I feel good.
Yours sincerely.
H.
*******
Dear h,
Apologies for the late reply. I'm on the road for a week with my son from NY, who I haven't seen in 4 years.
As for your medication, I share your opinion. The clopidrogel is actually enough. Your blood pressure will undoubtedly be too high at the oncologist. The reason for this is almost certainly the fact that such a visit causes considerable stress. I don't think the simvastatin is really necessary and the bifidobacterium certainly not.
The latter is based on somewhat outdated ideas from a few years ago, which will be followed stubbornly for some time to come.
Thrombosis, stroke, etc. are sometimes a consequence of cancer and often a first symptom. A possible additional cause. Oncologists are often not good at the treatment and follow-up treatment of thrombosis. That's not their job.
If you have any questions, I'll be happy to answer them.
Yours faithfully,
Martin Vasbinder