Explanation of a Health Check Up – Part 1
Fortunately, Charly's life is full of pleasant surprises (unfortunately sometimes also less pleasant ones). For several years now he has lived with his Thai wife Teoy in a resort not far from Udonthani. In his stories, Charly mainly tries to raise awareness of Udon, but he also discusses many other things in Thailand. He also gives a glimpse into his experience in Thailand.
Explanation of a Health Check Up – Part 1
Everyone has to deal with it at some point. Whether this is to respond to certain complaints and find out where those complaints come from, or in preparation for an operation, or for a periodic check-up (for example in case of diabetes) or simply because you want to know the state of affairs in which your body is located.
In the latter case we speak of a body check up or health check up. A number of functions of the body are measured and recorded in values. I underwent my last check up in 2014, in the Netherlands. Just before I settled in Thailand. Indeed, to know how my body was then. With the possibility to do something about it in the Netherlands in the event of any irregularities detected. Fortunately, nothing bad came out of that test at the time.
This month, six years later, I want to have an Executive Male test, as they call it, performed at the Bangkok Hospital in Udon Thani. Probably due to the lack of enough participants at the moment, this test is offered for the as yet not too bad amount of 17.500 baht, say Euro 500. Normally this test costs 31.000 baht (euro 885).
This time I would like to be well prepared for the test and for that reason I did two things. In the first place, all medical concepts of examinations related to the test were looked up and, secondly, a preparatory consultation was requested from the doctor under whose supervision the test will take place.
I have put together a short explanation of all medical terms that come with the test in this and subsequent posts. Of course, anyone can search the internet for medical terms and will therefore be able to find much more detailed information there. The overview is intended for those readers who need a short explanation to follow the test and who like to have all medical terms together.
The preliminary consultation with Dr. Weena will be at the Bangkok Hospital on Thursday, November 5, of course. First the usual introductions, such as of course checking my health insurance first and then measuring my blood pressure (I saw it was high, 164 to 94), my height and weight. Then I am taken to the waiting room, in front of Dr. Weena. Another nurse comes up to me and asks if I need an interpreter for the conversation with Dr. Weena. If so, she would like to take on that task. The sweet child's name: Ham. Still a very good service from the hospital.
I arrived at the hospital in plenty of time, knowing that the preliminary steps would take some time. So I'm in the waiting room on time. But that's no problem. My wife Teoy, the translator/nurse Noong Ham and I are in Dr. Weena. I take the Executive Male Test list one by one with Dr. Weena through. It is now becoming clear to me that noong Ham is needed more for the translation work towards Dr. Weena then for me. Strange that a doctor at this level needs help with the use of the English language. It's all in a friendly atmosphere and we get along very well together.
Going through the entire test was useful to understand the application and interpretation of the various components. To my surprise, two studies turned out not to be included in the test. Measuring the electrolytes (Sodium, Chloride, Potassium, Magnesium and Calcium), also important in determining whether the kidneys are working properly, and measuring the values of the various vitamins and minerals. At my request, both tests have been added to the test program. However, you have to pay extra for this. The consultation takes more than an hour and is not charged.
Noong Ham ensures that I get both appointments, namely those for the Executive Male Test in combination with the electrolyte test and the vitamin test, and for the discussion of the results of the vitamin test, neatly on paper. The discussion of the results of the Executive test takes place on the same day as the test itself. The discussion of the vitamin and mineral test a week later because it has been placed with another doctor.
Quite funny by the way. I see at least ten nurses at the desk where this is arranged. Certainly no understaffing on this. Would they be very jealous in the Netherlands, and I suspect also in Belgium.
The Executive Male test, the electrolyte test and the vitamin and mineral test are scheduled for Thursday, November 12.
Summary parts of the Executive Male Test:
- First a general physical examination by the staff of Doctor Weena.
It involves things like weight, height, blood pressure and checking your medical history;
- Chest X Ray. The heart, lungs and blood vessels are mapped on the photo;
- Urinalysis;
- Blood test with measurement values of:
- Sedimentation (sed rate), test to diagnose inflammation, such as arthritis or cancer, or infection;
- Hemoglobin, regulates the transport of oxygen and carbon dioxide through the blood;
- Hematocrit, indicates the amount of red blood cells in relation to the rest of the blood;
- Erythrocytes, these are the red blood cells. A test counts the red blood cells, including the immature blood cells (reticulocytes);
- MCV, indicates the average size of red blood cells. An MCV value that is too high occurs in anemia due to a vitamin B12 deficiency. An MCV value that is too low occurs in anemia due to an iron deficiency;
- MCH, is the calculation of the amount of oxygen that the hemoglobin carries in the red blood cells;
- LLC, is the calculation of hemoglobin concentration in red blood cells;
- Red blood cell width (RDW), is a value for the variation in red blood cell volume. The result of the RDW is interpreted together with the MCV. Platelets (platelets), ensure the clotting of our blood. If a blood vessel wall is damaged, the platelets stick to the damaged area. The platelets are formed in the bone marrow;
- Leukocytes (white blood cells), are cells involved in our immune system;
- Leukocyte differentiation, with the differentiation it is possible to look more specifically at the type of infection;
- Neutrophil granulocytes, play a role in the initial defense of bacterial infections and other inflammatory responses;
- Lymphocytes, can be divided into T and B cells. Form the memory of the immune system;
- Monocytes, an increased amount of monocytes indicates inflammation;
- Eoasinophilic granulocytes, especially combat infection from parasites such as tapeworm or malaria;
- Basophilic granulocytes, are the least abundant in the blood. The cells carry substances that can initiate an inflammatory response, such as histamine. These substances dilate blood vessels and make them somewhat permeable. This makes it easier for other cells to reach the inflammation. This also gives the typical picture of an allergic reaction, in which the skin turns red because the small vessels dilate;
- Blood sugar level to determine diabetes or no diabetes.
- HbA1C (Glyco hemoglobin), when glucose (sugar) from the blood binds to hemoglobin, HbA1C is created. Determining this value can tell something about the longer term of the blood glucose value, and the latter is important for diabetic patients. There is a better insight into the average glucose level;
- glucose, the blood glucose is the amount of sugar that can be found in the blood. The glucose values may or may not indicate the disease diabetes;
- Cholesterol is a soft, pale yellow, fatty substance found in cell walls and membranes throughout the body. Cholesterol is one of the fats (lipids) that the body produces. The body needs cholesterol. A person cannot live without cholesterol;
- Cholesterol total. By itself, cholesterol is not bad;
- Triglycerides is not a form of cholesterol but a blood vessel or lipid;
- HDL protects the body from cardiovascular diseases;
- LDL. In too large quantities, LDL is unfavorable to health and harmful to the body;
- Investigate liver functions (for an explanation of this and subsequent function, see my next posting).
- ASAT
- ALT
- ALP
- GGT
- Bilirubin total
- Protein total
- Albumin
- Examine kidney functions
- Blood Urea Nitrogen (BUN)
- Creatinine
- Creatine clearing (MDRD)
- Detection of uric acid in the blood
- Examination of thyroid functions (TSH)
- Examination of the prostate (PSA)
- AFP
- CEA (cancer)
- Examine faeces and blood in faeces
- ECG (cardiogram)
- Exercise Stress Test or an Echocardiogram
- Measure the bones
- Ultrasound Whole Abdomen
Is a radiological test for making images of the structure of the body, especially the abdomen and stomach area.
- Audiogram for testing hearing function
- Eye exam
- Intraocular pressure examination
- Examination of the retina (retina)
- Look far away
- Reading capacity of the eyes
- Examination of the blood type
- Determine blood group
- Fixing Rh group
- Investigation of hepatitis B, inflammation of the liver
- Using a INBODY machine determine various body characteristics, such as BMI (Body Mass Index), fat content, the amount of water in the body and the amounts of proteins and minerals.
An additional 966 baht must be paid for the electrolyte test.
This tests for:
- Sodium – Na
- Potassium – K
- Calcium (lime) – Approx
- Chloride – CI
- Magnesium–Mg
An extra test is also necessary to determine the different vitamin values, costs 11.500 baht.
I had misjudged myself on these last costs. I assumed that this test would cost a maximum of 3 to 4.000 baht. Of course I should have asked about those costs and unfortunately I failed to do so. Then I would have known this in advance and could still decide whether or not to do it. Tested include:
- Vitamin B12
- Folic acid (also called B11 or B9)
- Vitamin D
- Vitamin B1
- Vitamin B6
In the next posting a further explanation of kidney functions, liver functions and cholesterol. Then a closing posting with topics such as diabetes, PSA, TSH and of course the vitamins. Also in the closing posting a total overview of all test items and the associated normal values.
Sources consulted: on the Internet, including Wikipedia, the Heart Foundation, Sanquin, the Dutch Society for Hematology, Lab Results, Human and Health and others.
At work, through my work, a small health check-up is offered annually for free.
I used to go there a long time ago, but since my friend Tino (retired GP) advised me not to go there if you feel well, I don't go anymore.
And what do you think: I feel a lot and getting better.
Tino can undoubtedly explain better why if you are 65+ and feel good, you should not go there, apart from the costs.
All right Chris, let me say a little more about it. All long-term studies into the effect of preventive health screening in people who have no complaints show that neither the number of cases of illness nor mortality decreases. A short example. If you do 10 tests in healthy people, on average one test is abnormal. Other literature sometimes paints a negative picture: more unnecessary research and interventions. See this literature:
https://time.com/5095920/annual-physical-exam/
Quote:
As a result of these lackluster findings, some experts have called for an end to annual physicals.
“If you're healthy, there's every reason to believe these visits make no difference,” says Dr. Ezekiel Emanuel, a professor of health care management and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania's Perelman School of Medicine. “Doing a bunch of unnecessary tests and taking up valuable time for people who are well—that's not useful.”
Here is a very large study with more than 180.000 (!) participants over many years:
https://www.bmj.com/content/345/bmj.e7191
Results:
We did not find beneficial effects of general health checks on morbidity, hospitalization, disability, worry, additional physician visits, or absence from work, but not all trials reported on these outcomes.
conclusions
General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although they increased the number of new diagnoses. Important harmful outcomes were often not studied or reported.
And this comprehensive study (Systematic Review: The Value of the Periodic Health Evaluation
https://www.acpjournals.org/doi/10.7326/0003-4819-146-4-200702200-00008
Quote:
In summary, this systematic review demonstrated that the PHE has a beneficial effect on the delivery of some clinical preventive services and may have a beneficial effect on patient worry, providing justification for its continued implementation in clinical practice. Further research is needed to clarify the long-term benefits, harms, and costs of undergoing the PHE and to weigh the value of receiving clinical preventive services and worry relief in the absence of evidence demonstrating such long-term clinical benefits.
Note: some, may have, further reach is needed., absence of evidence of long-term clinical benefits.
Benefits in terms of long-term health could therefore not be demonstrated. It did, however, reduce patient anxiety.
A healthy lifestyle is much more important. Exercise a lot (most important), eat healthy, don't smoke.
If you feel otherwise healthy, do not do any health tests. Superfluous and sometimes detrimental.
I (as a non-doctor) fully agree with you, but I do have a question that you as a doctor may be able to answer.
What about the studies that are offered to people in NL, for women including breast examination and smear and for both the bowel examination.
Has the benefit of this been demonstrated?
Very good of you to point that out to me, Bert. Yes, there are some proven studies like the three you mentioned.
In addition, there are certainly questions about mammography for the detection of breast cancer. Here eg:
https://www.henw.org/artikelen/massascreening-met-mammografie-feiten-en-misleiding
Quote:
Conclusion
The exact size of the benefits and harms of population screening for breast cancer is open to debate. What is certain is that women who are considering participation are deliberately misled.1718 In the absence of correct and interpretable information, there is no question of informed consent. GPs must inform their patients correctly and in absolute terms about the advantages and disadvantages of participation. For every thousand participating women, followed up for ten years, one case of breast cancer death could be avoided, at the cost of five unnecessary cancer diagnoses. The evidence for any beneficial effect of mass screening with mammography remains very thin. Due to the ever-improving treatment of breast cancer, the added value of mass screening is becoming increasingly uncertain.
For now, I think mammography is helpful. The damage caused by some population screenings is rarely, if ever, included in the final assessment.
Although I have a favorable view of public health and health care in Thailand in general, there are certainly some excesses that serve only as a revenue model and not for the health of the patient. In the Netherlands sometimes but much more in our beloved Thailand. .
Tino,
Thank you for your extensive documentation. It can help to keep people over 65 out of the anxiety zone that often causes check-ups. Fear is a perfect revenue model for the pharmaceutical and medical equipment industry and unfortunately also for many colleagues.
Of course, everyone is free to look for the hidden ailment, which in the hands of the wrong doctors can significantly lower the quality of life.
Just think of the initial placebo effect of antidepressants. When that is gone and the pills no longer help, it is very difficult to kick the habit because of the withdrawal symptoms, which have nothing to do with depression, but all the more with addiction.
Wise words from Tino Kuis. In addition, commercial hospitals in Thailand see these check-ups as a "dragnet". In many people, something more or less abnormal is found and hallelujah: their hospital has the necessary (?) treatment for it. You'll be in the medical mill before you know it. If you hadn't had a check-up, you would die much later with, but not BY, your "condition". A good example is the PCA laboratory test, which indicates prostate problems. Having worked in an operating room for years, I suspect that many men have undergone prostate surgery, partly "provoked" by this test. Many men are afterwards incontinent and impotent. In short, without this operation they would have died with their slow-growing prostate cancer, but not because of prostate cancer.
Tino rightly says that a healthy lifestyle makes much more sense: exercise. watch your weight, don't smoke and drink alcohol in moderation. This healthy lifestyle is also less attractive to me: it takes effort 🙂
@Tino
Nice, such a selection from scientific reports. But of course that means nothing at all.
I think there are at least as many scientific reports that claim the opposite, namely that early testing does make sense.
Yours sincerely.
Charly
I completely agree with Tino on this one.
Do this kind of testing here in Korat in the st Mary hospital, they have a 'street' where you can check various health, of course, do this for outdoor clients for a fee.
Are slightly better priced than the prices quoted by you.
The most expensive normally comes to about 10000 Baht, sometimes a few days a month, usually in the first week it is half price.
Of course I will register and pay during that period, you can also have the test itself done after those days, but in the current month.
Last time I was 18 months between the first and the second health check.
English speaking doctor when handing over your healtcheck booklet was very satisfied with this snapshot.
Sign up again with my 68 springs.
Broadly speaking.
Check eyes
Blood collection with extensive control
Heart movie making
X-ray
Echo organs
Check urine
Appearing 'fasted' [no drink or food in last 8 hours]
Present for about 4/5 hours
Have you paid a lot, Bangkok Hospital Phuket 11.900 ฿ incl intestinal examination.
If you have that blood test done in a state hospital next time, you will be a lot cheaper.
I have tested blood values for 23 (I'm not going to write them all down) including the 5 electrolytes paid 920 Baht some time ago.
Charly, you say, had it checked in NL in 2014, shortly before emigration, and in 2020 you emigrated definitively, so you did 4+8 for a few years. Couldn't you have had this done much cheaper, or even free, in NL via the health insurance policy? Did you save a lot of money.
Phayao Ram hospital: 8000 bath
Regards Adrian
You have done a great job and are well prepared to read this. I also do these kinds of tests every two years and I feel comfortable with that. It is better to be well informed and to know how things are going. In the event of any disappointing news, a well-considered decision can then be made, but I like being there on time.
I do think a price comparison is in order and as part of your preparation I am missing this in the story. The last time I had this kind of research done in a state hospital and the prices there range from about 6000 to 10.000 baht. This contains the most necessary and is therefore not as extensive as you have done. In my opinion this is not necessary in the first instance. Bangkok hospital in Pattaya also has packages and averages around 12.000 baht and sometimes on offer for even less, such as in the sister hospital Jomtien.
I wish you success with the results and 164- to 94 requires some attention, but you know that yourself.
@James
Thank you for your response.
Indeed, I did not do any price comparison research this time. Of course I could have requested quotes from the AEK hospital and Wattana hospital. Maybe something for next year.
In all cases I talk about hospitals in Udonthani because I live close by.
So there is much less price comparison to do here, as in Bangkok, for example.
Oh, and about that 164/94. Yes, if that were standard with me, it would be very disturbing.
But fortunately that is not the case. I regularly measure my blood pressure at home and then I am in fact always in the right tables.
Yours faithfully,
Charly
Hi Chris,
I am an 86-year-old man and I also have a simple health test done annually by means of a blood and urine test and an ECG. Costs between 2 and 3000 baths. (not in a private hospital and certainly not in the Bangkok hospital) The results are always acceptable, so I have no complaints. I would like to know why Dr. Tino advises not to do this if you feel well. I have also wondered myself whether this is necessary, if you never have any complaints, but always thought: “If it doesn't help, it won't hurt.
If you do something in healthcare that does not benefit, it will always harm to some extent. Often small, sometimes a lot.
Sorry Chris,
I now see that Dr. Tino has already answered. My thanks for that. Got a little wiser.
You can go straight to a lab for most blood and urine tests.
A hefty price for a health checkup. Quite a bit more than a few years ago at the Bangkok Hospital in Hua Hin. The Bangkok Hospital is good at math! And they had come up with a trick to get even more money, namely by sending you to a different specialist for each part for a final interview per part.
If I get the chance, I make sure not to go near doctors and / or hospitals.
But sometimes I consciously choose that. Like now with the Executive Male Test.
Such an extensive health up check can ensure that certain ailments/irregularities are detected at an early stage. As an example, I will mention elevated cholesterol levels, which without being tested, you will not notice until it is too late. With regard to the results that emerge from such a test, you have to judge for yourself what you are going to do with it.
So I do not agree with Dr. Tino not to undergo health tests.
To measure is to know, and that certainly applies here.
I will discuss some of the results of my test at Bangkok Hospital.
1. Reading function of my eyes has deteriorated sharply. Received a note from the ophthalmologist with the relevant values and bought new reading glasses a few days later.
2. The Uppersound Whole Abdomen shows that I have a severely fatty liver. My reaction / action: adjust alcohol consumption, as well as diet and daily consumption of lime juices.
This radiological examination also showed that I have several gallstones. My reaction / action: do nothing until the moment comes when I start to suffer from gallstone attacks.
3. The same test revealed an enlarged prostate. My reaction/action: don't do anything about it. My PSA is
2.5 so absolutely not in the danger zone, it seems.
It is then nice that I can conclude that I do not have elevated cholesterol and a good HDL figure, all liver-related values look very good and that the kidney function may need some attention. Furthermore, the ECG and Ultrasound diagram are excellent, as is the X-Ray.
I like to know all the results from the test and react to it with my own mind.
Again: measuring is knowing.
I like to believe that such tests in the state hospital will be considerably cheaper. But I don't like to spend the whole day in a hospital like that between whining children and Thai families. But to each his own of course.
The different rates mentioned here and there cannot be compared. For this you would have to compare the entire test package of the various providers.
Yours faithfully,
Charlie.
Totally agree with you Charlie.
It is a snapshot that you can respond to and thus slow down / stop any problem.
Preventive always helps in this part of the world where limited problems can quickly cost a lot of money that are often only reimbursed to a limited extent by many foreigners.
To measure is to know is very correct.
"A healthy person is one who has not been examined enough" was a sarcastic joke among doctors. If you do enough research you will always find something. The question is whether you get anything out of it.
Doctors should promote a healthy lifestyle. If they only give advice when deviations are found, they are doing it wrong. Go for a nice walk, moderate alcohol, healthy food and don't smoke, then you don't need tests.
Dear Charly, I have no objection to you having these -whatever it's called again- tests done. Go ahead. But don't try to fool anyone into thinking it's good for your health. That's my point.
@Tino
Dear Tino, nowhere in my posting do I claim that a health check up is good for your health.
Don't put words in my mouth that I haven't used.
I also stick to my point of view that to measure is to know. And I continue to find it amazingly arousing that your opinion is that health check ups are good for nothing. I have already given as an example that an elevated cholesterol is not noticed by people. It is a silent killer that can come to light in a neat, timely manner during a health check. I am not a doctor, but I can imagine that there are still more diseases that can be detected with a health check up, whether or not in time.
I actually suspect that your objections to health check-ups mainly stem from your, justified, annoyance that hospitals sometimes ail you and try to talk you into appropriate solutions based on the results of such a test. You got that absolutely right. But my point of view is that people can decide for themselves what to do with the results of such a test.
Yours faithfully,
Charly
The link below (from Harvard Medical School) gives the same picture as Tino and Maarten. In America, an 'annual physical' is very common and is covered by insurance. I recently underwent one (two pages with results and comparison with 'normal values'). My cost: $0; once a year. I can decide for myself what to do with it.
The question is: if it is so useless, why do insurers (in America) cover the research costs? I assume that in the rare (?) case of early detection, the savings are so great that it is worth the reimbursement costs.
I can imagine that older expats in Thailand with limited resources and no insurance want to be on the safe side with such a test. After all, how many people who felt fine had a brain hemorrhage or heart attack? Rare? Maybe, but, as Charly said: measuring is knowing.
https://www.health.harvard.edu/blog/a-checkup-for-the-checkup-do-you-really-need-a-yearly-physical-201510238473
Charly is free to disagree with Dr. Tino. The latter has good scientific arguments for his opinion: extensive research has clearly shown that people who undergo check-ups do not live better and longer. That is why people in NL and Belgium do not do these types of commercial check-ups.
Lime juice as a treatment for liver ailments doesn't seem scientifically substantiated to me, but if Charly likes it, it's fine of course. I hope he has been advised by the Bangkok Hospital to have his blood pressure checked regularly. Purchasing a good automatic blood pressure monitor seems to me to be a wise investment. Was 164/94 but a one-off measurement doesn't say much.
Maarten and Tino are both doctors. You don't just become a doctor. You disagree with them, are you sure you're smarter?
@Johan (BE)
I regularly check my blood pressure at home with my own blood pressure monitor. And at those readings, my blood pressure is always excellent.
The fact that I mentioned the daily use of lime juice is just one example of the adjustments I make to my eating and drinking habits. I don't find that highlighting very stylish and it comes across as sought-after. Maarten and Tino are indeed both doctors, but that doesn't mean they have to express the only correct opinion, right?
I'm not at all concerned with demonstrating that I would be smarter, although that can certainly not be ruled out. I have an opinion, and others have a different opinion.
There is nothing wrong with that.
Yours faithfully,
Charly
Charlie,
You yourself have propagated lime juice as a cure for liver ailments, so don't get angry if I respond to that.
And further: you have an opinion and others have a different opinion. Is fine indeed.
I only react a little irritated when you (probably unintentionally) "advertise" medical check-ups by the medical industry, when sound scientific research has proven that it doesn't make you live longer or better.
But you don't harm others with it, so it's fine as far as I'm concerned.
@Johan (BE)
I didn't propagate lime juice at all. I've only mentioned it as one of the steps I'm taking to adjust my eating and drinking habits. For example, I have now also resorted to a few Herbalife products to promote weight loss in particular.
And I don't really promote taking health check ups, but I do recommend it to everyone. Measuring is knowing. And then doctor Tino can say that it makes no sense and that it has been scientifically proven that no one gets better or lives longer as a result, but those are studies selected by him to prove his point.
I myself have made it clear with my test that it is indeed useful to have yourself tested.
Furthermore, these tests are provided free of charge by insurance companies in America. They certainly don't because they've suddenly been bothered by a philanthropic institution.
And undoubtedly there are scientific studies that just as easily disprove Dr. Tino's right. I don't have such boundless confidence in family doctors as you seem to have. Up close unfortunately had to experience quite a few mistakes from general practitioners (in the Netherlands).
Yours faithfully,
Charly
Dear Charly, or should I say Dr Charly.
I think you're quite impressed with yourself.
Have you met Narcissus?
That's why you go way too far in your comment.
Your whole story would get a zero on a freshman exam, probably because you're smarter than everyone else, or so you seem to think.
That's why I advise you to stick to your reading, if you have it.
Just keep writing about wine, food and other delights. You won't hurt anyone with that. I will therefore no longer respond to your raving, otherwise I can unfortunately not mention it.
@ Maarten Vasbinder
Now you may be the family doctor of this blog, that does not give you the right to respond to my posting in such an oversimplified manner. I have done nothing other than explain exactly how I arrived at my health test and how I further underwent it.
Then suddenly two GPs arrive who agree with each other and both hold the view that health check-ups serve no purpose. I refute that in normal language and do not cross the line anywhere, although I have felt the need to do so from time to time. There are quite a few commenters here who just happily hobble along behind your opinion and that of doctor Tino, without any facts. Donald Trump would say: all fake news.
I also take the trouble to speak nicely to a number of commenters.
The attack you wish to place in your message comes across as emotional and rather stabbing. Not written with an open mind. Too bad, but here, just like doctor Tino, the family doctor of this blog also falls through the month.
Yours faithfully,
Charly
That is why people in NL and Belgium do not do these types of commercial check-ups.
Disagree with you on this John.
It is indeed possible in the Netherlands and Belgium, only general practitioners are not happy with it, as is also evident here.
Often 'free' after insisting with the doctor, but you can also buy it yourself and that seems commercial to me.
https://www.thuisarts.nl/medische-keuring/ik-wil-medische-check-laten-doen#meer-informatie-over-gezondheidstests
https://chirec.be/nl/centra/508000-medische-check-ups-particulieren-en-bedrijven/
I find it amusing when I see all those different tests pass and those prices. Unbelievable!
If you really have a problem you go to a doctor and possibly the hospital. You indicate what the complaint is or where you suspect that something may be wrong. And then you get checked out. And that must be it. If something emerges that really requires attention, a process can be started for it.
Those large overall examinations when you feel healthy and have no complaints is pure waste. For the hospitals it is just marketing to create continuity for their medical staff.
I went to a small clinic last year with a targeted care. An illegal rubbish dump right in front of my house gave a sickening smell to my house and I was concerned whether the chemical waste that might also be present was harmful to my health and especially my fragile lungs (had Hong Kong flu with complications on my lungs).
The overall examination meant that blood and urine were examined in the lab. Furthermore, blood circulation, heart function, liver, kidneys, prostate, glucose, cholesterol etc etc were examined, Electrocardiogram. Everything neatly reported. Cost 2.500 bht.
What is the point of knowing exactly what it is like with a certain vitamin. That may also be a snapshot. My motto: Listen to your body and take care of it. Such large-scale research is looking for those needles in a haystack. If there really is something, then that large-scale investigation is not necessary.
Charly, you've done some work on it.
I'll leave aside whether it's useful to know everything.
After all, it is your decision and your money.
However, I wonder how far your health insurance fits into the picture, because you explicitly state that your health insurance was checked immediately in the preliminary interview.
It is a hefty amount so my question is whether your health insurance will pay for these kinds of investigations.
If so I would like to know what and which health insurance you have .
I read many of your posts and therefore assume for the sake of convenience that you are no longer insured in the Netherlands because you have your domicile here.
@Rick
No, my health insurance, AXA, does not pay for this Executive Health Test. I am only insured for in-patient and this test is therefore not included, because it is out-patient.
Yours faithfully,
Charly
Charly, the Bangkok Hospital could also have admitted you for a night if you had asked. Last year I had some problems and they wanted to do a check up. Because I thought the costs were a bit high, the doctor suggested that I be admitted. Testing and 2 days of admission cost 36.000 baht, which was paid for by my insurance. The medications were also reimbursed by insurance for 3 months afterwards. The latter is not paid for by every insurance company.
Dear Ruud NK,
The hospital admission for 1 night is done to convince the insurance company that it was an “emergency”. Or the patient is only insured for costs upon admission and not for outpatient visits/consultations as an “out patient”.
In fact, I think it's a form of fraud. It then seems acceptable (?) to let the unsympathetic insurer pay, but it does drive up the premiums for everyone.
@Ruud NK
Smart doctor Ruud. Unfortunately, I myself, and also the doctor treating me, was not so smart to come up with that. Would have saved me about 40.000 baht in total. Not really saved because I have a deductible of more than Euro 6.000. But then that deductible had already been nibbled away quite a bit. Sigh, I'm much re good for this world, 55555.
But thanks for the tip Ruud. I'll definitely keep that in mind on the next occasion,
Yours faithfully,
Charly
@Louis
Going to a doctor or hospital if you have a medical problem seems logical to me and an open door from here to Tokyo. But what if you are actually late with your visit to that doctor or the hospital?
If nothing can be done about your ailment.
At that point, I think, you wish you had known about the existence of that ailment sooner. Well, that's exactly what the health check ups mentioned are meant for. The timely diagnosis of an ailment, at an early stage. With that certainty? Not that, because such an ailment can of course also arise if you have just undergone the health check. It remains a snapshot. That is why it is also good to undergo such a test regularly, for example once a year. And completely natural if you have some vague complaints.
And determining the vitamin values is also important.
Yours faithfully,
Charly
In the past, when I went to Thailand for at least 2 to 3 years, I had such an MOT done every other year. Not especially to detect hidden problems, but also for your own reassurance. Bumrungrad cost a THB 2010 sometime around 14.000. Very good explanation and especially what was wise to do differently. In 2016 Thai Nakarin, a THB cost about 11.000 including a course that included everything in a conversation of about 1 hour. Final conclusion: if it is only because of these problems, you will live to be at least 125 years old.
If you are late there is a chance that you will die. But what's the problem with that? You must die anyway. And if you're over 70 like me, it doesn't matter that much anymore. I've already had a long and happy life. It may be over for me.
@Fons
Well, if you've had enough of life, if you're tired of life I'd say, then such a health check makes little sense. However, I live differently. I am 73 and I would like to last a few more years, but in good health. In that context, a regular check-up of my health is very useful.
And I'm definitely not a fan of D'66.
Yours faithfully,
Charly
Pfff, I'm not tired of life and yet I don't participate in that nonsense. Something for the faint-hearted who think it will help them live longer. I feel fine and as long as it stays that way no nonsense.
@Han
There are many kinds of people, including the faint-hearted but also ostriches.
I consider myself to be a bon vivant and realist.
Yours faithfully,
Charly
From your stories you are certainly a bon vivant Charly, but if you really hang on to life like that you will have to adopt a completely different lifestyle.
Not that I'm wrong, I also enjoy life with good food and a glass of wine on time. Nothing wrong with it.
If you are insecure and live with fear of having a disease among the members, you should definitely do that, constantly being insecure whether you have something among the members seems quite stressful to me.
I think a healthy lifestyle is much more important, prevention is better than cure. I know people who are quite overweight and/or have a significant daily alcohol consumption, who have themselves checked every year because they want to “stay healthy”. In the Netherlands they call that mustard after a meal.
Staying at a healthy weight, not too much alcohol, healthy eating, enough exercise, etc.
Checking important medical matters such as blood pressure, sugar, cholesterol, and participating in population screening such as colon cancer I understand, but I will never have such an extensive check up done.
Much more important, as mentioned several times here, is healthy living, drinking a glass in moderation, not smoking and exercising properly, so that you have a healthy BMI. Here in my area I see many people who live unhealthy lives and therefore get scared and have an extensive check up done.
Dear Charly, there is of course no reason to doubt the literature mentioned by Tino as you do, because Tino and Dr. Maarten are certainly capable of separating the wheat from the chaff. You should actually appreciate that both doctors have responded because that makes your story more valuable. By the way, I don't intend to have a full investigation done myself.
Your comment that US insurance companies are not philanthropic institutions is of course true, but it is quite possible that without that indemnity clause the policies would be hard to sell. In any case, that clause does not help to bring life expectancy in America to a reasonable level because it is downright lousy.
On the other hand: in that literature it is of course about averages and you are not an average person. I assume that you will not blindly follow a doctor's advice to undergo surgery (see prostate). And if you don't follow it, you won't have sleepless nights. This way you reduce the chance of the potentially negative consequences of such a health examination. And of course there are also positive sides to such a study. For example, if they find that there is too little vitamin B12 in your blood, you can prevent major problems with a daily tablet.
But beware, you are not only dependent on the expertise and integrity of the doctor, but also on the reliability of the measurement results. Is the analyst competent, is the measuring equipment calibrated on time? Were the calibration fluids not out of date? And so forth. And then there may also be a snapshot, which is of course very evident in the case of blood pressure.
Your comment “to measure is to know” is of course justified. But you have to do that yourself, and of course you already do that by measuring your blood pressure yourself. But do you know, for example, what your resting pulse is and what your maximum pulse is? And do you measure your physical abilities? I myself started doing some sports again 8 years ago and after more than a year I was at an acceptable level when it came to running. For example, I regularly run a 50, a 100 and a 130 meters on my own country (on a somewhat bumpy surface) and I also regularly go to an athletics track for a 100 and 400 meters. I collect those times in a spreadsheet and I have now managed to run the same times for 6 years without having to invest a lot of time (well less than an hour of running per week not counting the rest times, but the 10 minutes that I'm in the field for every football match; I don't do stretching). Not only does measuring and recording make running interesting and therefore easy to maintain, but my time of one and a half minutes over the 400 meters is an indication to me that my circulatory system is in good shape. I also see confirmation of that conclusion in my blood pressure values. And to top it off, I also know that my skin temperature doesn't drop much when I perspire, which is an indication that the capillaries in my skin haven't clogged yet. If an examination shows that my cholesterol is (too) high, this will not be a reason for me to stop putting whipped cream in my coffee, for example. I would then conclude that in my specific case a high cholesterol level can do no harm. I would assign a much higher value to my own measurements (blood pressure, 400m time, skin temperature). So: measuring is knowing, yes, but don't just rely on some laboratory data.
By the way, of course I appreciate that you raised this and provided us with quite a bit of information. I was surprised that so much can be measured.
Keep it up!
@Hans Pronk
Thank you for your very meaningful contributions. Fortunately, there are still commenters like you who can respond nuanced.
Yours faithfully,
Charly
Dear Hans Pronk
This introduction reminds me of my unfortunately prematurely deceased mother 'the pastor and the doctor are always right' A prejudice as many know where you already indicate which side you choose without a doubt.
Fortunately, doctors are also just people who are guided by more than Western science. [really and truly]
Dear Charly, there is of course no reason to doubt the literature mentioned by Tino as you do, because Tino and Dr. Maarten are certainly capable of separating the wheat from the chaff. You should actually appreciate that both doctors have responded because that makes your story more valuable. By the way, I don't intend to have a full investigation done myself.
Preventive checks are carried out all over the world and for various reasons here in Thailand it does no harm as a fragile person with a different health care system [financially] than in the Netherlands.
I had myself checked twice after I turned XNUMX, as mentioned earlier, little tidbits and facts, so far I will live longer 'no idea' will it make me or remain healthier 'no idea' I will try in addition to my now 'healthy lifestyle' ' to reach the expected years of life according to various authorities as healthily as possible, of course, but yes, the total years of life also contain some black pages, so to speak.
The theory of healthy living is ALSO a snapshot.
There are always two fronts to a discussion like this if you're lucky three of course I understand the author's approach well and see the benefits of it there are many things in the human body that
IF it happens to you, it is of course clear that you should always register freely, often with the necessary drama. It is of course clear that you should not rush through checking.
But if you feel healthy, it is not necessary, but it is very short.
Dear William, even if you feel healthy you can of course have something among the members. And that could indeed come to light during an investigation. And of course, early treatment often has benefits. All true. But mistakes are made in those studies. Moreover, the advising doctor will always have his doubts - if he is a good doctor - but advice is expected from him. That will sometimes be wrong advice and lead to an unnecessary operation. And even if the operation is not unnecessary, the operation can still be worse than the disease, just think of operations on the prostate with often unpleasant side effects. But if you think you're doing the right thing, then of course you should. But before you agree to a treatment, I would ask for a second opinion just to be sure, but I hope of course that will never be necessary for you.
Ah yes, someone from the third front or the midfield.
And yes, it is not only the doctor who sometimes makes the wrong conclusion and these types of studies can also come to conclusions that are not necessary or that are much too early.
If the figures or images are not really correct, you can make an appointment in the hospital I mentioned with another specialist, you don't want that right.
You can assume that you recognize that situation in Thai healthcare.
A second opinion/research, yes, the more risk involved, the more credible opinion/advice you are looking for, people here are more likely to resort to 'made of thick wood' solutions than in the Netherlands, so that can't hurt and people really don't mind it either. .
And as you probably know, much if not everything is readily available in most hospitals.
That surprise sometimes scares you, certainly don't let yourself be talked into a treatment because the speed in 'service' can save you quite a bit in the invoice.
That's why I appreciate this kind of preventive control here in this country so that you hope a little more than you can get a broader opinion / advice in case of problems, as you also indicate.