Mubvunzo kune general practitioner Maarten: Matambudziko emudumbu, diuretics uye pulmonary embolism.

Maarten Vasbinder anogara kuIsaan. Basa rake ndere general practitioner, basa raainyanya kudzidzira kuSpain. PaThailandblog anopindura mibvunzo kubva kuvaverengi vanogara muThailand uye anonyora nezvechokwadi chezvekurapa.

Iwe une mubvunzo kuna Maarten uye unogara muThailand here? Tumira izvi kumupepeti: www.thailandblog.nl/contact/ Zvakakosha kuti upe ruzivo rwakakwana se:

• Zera
• Zvichemo)
• Nhoroondo
• Kushandiswa kwemishonga, kusanganisira kuwedzera, nezvimwewo.
• Kusvuta, doro
• kufuta
• Optional: mhedzisiro yerabhoritari uye kumwe bvunzo
• Zvinogoneka BP

Unogona kutumira mafoto ku [email inodzivirirwa] zvese zvinogona kuitwa zvisingazivikanwe, zvakavanzika zvako zvinovimbiswa.

Wadiwa Martin,

Ndiri 65 ndinogara muThailand kubvira 2004. Vakaroorana, vaiva nenguva inoshungurudza, uye 4 bypass muna 2015. Ndakaudzwa kuti ndinofanira kutora mapiritsi emvura katatu pazuva, kuwedzera kune zvimwe zvinhu zvinozivikanwa, kwehupenyu hwangu hwose. Ini handina kugara ndichirarama maererano neizvi, uye (zvinonzi!) ndakatambura nepulmonary embolism (nam tuam phot) semhedzisiro muna 3, ndakapona nepaburi retsono.

Mazuva matatu apfuura akabvuma zvakare kuburikidza nechimbichimbi ane zvakafanana (zvinyoro) kuongororwa mushure me x-ray mhedzisiro. Kugara pamubhedha kwemazuva maviri. hapana drip, hapana mumwe mushonga, akatenderwa kuenda kumba mushure me x-ray yechipiri, nemishonga yematambudziko angu emudumbu ayo HANDINA zvachose. Pharmacy yakashamisika, yakashamisa vamwe vanachiremba, asi iye zvino (kunyangwe zvishoma zvakanyanya) matambudziko ekufema, nekuedza kudiki.

Zera 65, uremu 108 kg, 1,82 kureba. Mushonga:

• Lipitor/platogrix
• vastarel
• alprazolam (o.25) 2
• caretes
• Tramadol (yakabatana netsaona) 50.mg katatu zuva nezuva 3
• dominex….domperidone
• simethicone

Mubvunzo wangu uri mupfupi, mishonga ine chekuita nemudumbu iyi ihama here? Uye mungandipa zano here kuti ndikumbire pfungwa yechitatu? Ini ndinoona zvichishamisa kuti ini handina kunyatso kurapwa asi ndaigona kungoenda kumba, kutya kunokunda mundangariro dza2017.

Kwazisai,

H.

Anodiwa Henk,

Nyaya isina kujeka zvishoma. Ini ndinokahadzika kuongororwa kwepulmonary embolism uye ndinofunga nezve pulmonary edema (mvura mumapapu). Izvi zvinogona kuitika, pakati pezvimwe zvinhu, nepulmonary hypertension. (PAH)

A pulmonary embolism inenge isingakwanisi kuonekwa pa X-ray iri nyore, uye chimiro chakapfava hachina. Unyoro, kune rumwe rutivi, unogona kuona uye kunzwa pakarepo.

Ndeapi mahwendefa emvura awaifanira kunwa? Mimwe mapiritsi emamwe mapiritsi akaita sei?
Chikonzero nei uchifanira kutora Vastarel (trimetazidine) mushure me 4 bypasses zvakare haisi pachena zvachose kwandiri, kunze kwekuti kushanda kwakundikana kana kusina kuitwa.

Zvishandiso zvemudumbu mako zvakatonyanya. Uyezve, kune nzira dziri nani zvikuru.
Huremu hwako hwakanyanya uye handingashamisike kana imwe yacho ichiyerera. Unombozvimba tsoka here?
Ruzivo rwakawanda rwaizobatsira kupa zano riri nani. Nei paine mipata? Kumanikidzwa kweropa. Kusvuta. Doro. etc.

Ndakaperera,

Dr. Maarten

Wadiwa Dr Maarten

Kungori rekodhi ndakaona kuti mwedzi mitanhatu yekupedzisira ini ndinogara ndichitambura ne 'mablanks' kana maburi asingatsananguriki mundangariro dzangu, asi izvo parutivi. Chekutanga kutenda kwakawanda nekuda kwemhinduro yako uye zviri pachena kuti iyi ipulmonary edema, iyo yakapotsa yandiuraya makore maviri apfuura, munguva chaiyo kuchipatara chehurumende, mazuva 6 ICU pasvondo ndichipora. ZVINO kutanga fomu remvura kumashure / mumapapu akaonekwa Svondo rapfuura.

Kubvumirwa kupinda, asi hapana kutevera, chimwe chinhu chisingawanike muno muNongKhai.Ndinowanzova neruzivo rwakanaka pachipatara chikuru nongKhai. Mushure me x-ray nyowani ndakakwanisa kuenda, asi ndinofanira kudzoka Gunyana 16. Uchiri nedambudziko rekufema.

Ini handisvuti kana kunwa, kwete donhwe redoro kwemakore gumi nemashanu, ndakarega kuputa nekukurumidza mushure mekupfuura. Kufutisa, hongu kunofanirwa kunge kuri kutenderera makumi mapfumbamwe.

Chikonzero Bypass: Multicultural Marriage (Laos) Autistic Son (ikozvino 15) uye Bhizinesi Sarudzo Izvo Zvisina Kundibata.

Zvadaro kutevera muKhon Kaen uko kwakaitika nzira yekunzvenga. Gore rekutanga hapana dambudziko, iyo SR cardiologist yaive nzvimbo yekuonana, asi mushure megore (2016), iye akasiya basa uye ini ndaifanira kutarisana nevarapi vaiuya, kazhinji vese vane ego yavo uye kutadza kutaurirana. Ndinotaura chiThai chinonzwisisika, asi ndiri mupfupi panyanzvi dzekurapa.

2017: Mushure mekuedza PSA mwedzi mitatu yega yega kwemakore mashanu, TURP uye nhamba yebiopsies, imwe nzira yekenza yeprostate yakaonekwa. Zvichakadaro zvakare yakatungidzirwa muKKU (Srinagarind), asi matambudziko erection asara, achishungurudza zvakanyanya.

Mbudzi 28, 2017: pulmonary edema. Ndichingosvika patrauma ward, hope dzakashata. Zvakafamba zvakanaka, asi ipapo piritsi rakaipa renjere kwandiri munyaya iyi. Mahwendefa emvura. Ndaitarisirwa kunwa piritsi rimwe katatu pazuva, ndapererwa nemvura uye ndaisatombokwanisa kutora nhanho ndisina kuita weti. Mushure mekubvunzana muKhon Kaen, inodzoserwa kamwe chete pazuva uye kunwa zvinwiwa zvishoma. Zvinoita sezvisingashande zvakadaro. Sei mushonga uyu kana kwete, haugoni kukurukurwa. Vanachiremba veThai kwete 3 kunze kwemuchiitiko CHANGU HAZVIKOshese kubvunza mibvunzo, ini ndinoita zvakadaro uye izvo zvinounza kusawirirana, kana dzimwe nguva kunyangwe kukakavara.

Rondedzero yemishonga kubva khon kaen:

• Atorvastatin Sandoz 40 mg 1 piritsi s'avons mushure mekudya
• Careten 6.25 mg 1/2 piritsi mangwanani uye manheru mushure mekudya
• Clopidogrel 75 mg piritsi rimwe mangwanani mushure mekudya
• Vastarel 35 mg 1 piritsi mangwanani uye 1 piritsi manheru mushure mekudya
• Alprazolam 0.5 mg sezvinodiwa panguva yekurara (kazhinji kushaya hope) (kwete mukati mezuva)
• Furosemide 40 mg …….3 piritsi katatu pazuva

Mwedzi mitatu yega yega kuongororwa ropa kweprostate uye nyaya yemoyo. Prostate ikozvino 3 pp. ropa values ​​normal.

Kwazisai,

H.

Anodiwa h.

Wakambosangana nezvimwe zvinhu.
Zano rangu rekutanga nderechokwadi, ona mumwe chiremba.

Kana zvichidikanwa, zviedze iwe pachako pulmonary hypertension (PAH). Izvozvo zvinogona kukonzera mvura mumapapu ako.
Pulmonary hypertension inogona kukura kana ventricle yakarurama yemwoyo yakawedzerwa.

Kana paine PAH, mushonga unofanirwa kuchinjwa zvakanyanya. Semuenzaniso, unogona kunyorerwa Tadalafil (Cialis).
PAH iri kushomeka saka hachizove chinhu chekutanga chavanotarisa.

Kuruboshwe ventricle yemoyo inogonawo kukura, izvo zvinogona kukonzera kupfupika kwekufema. Yakanyanya kuwanda uye inogona kuve nezvikonzero zvakawanda, senge high blood pressure uye mavharuvhu matambudziko.
Matambudziko evhavha anogona kuonekwa ane echocardiogram, uye stethoscope virtuoso inogona kuanzwawo zvakare.
Mwoyo wakaita contours unogona kuonekwa pachipfuva che X-ray uye neCT scan munhu anogona kuona mwoyo wose.
Iyo midziyo inogona kunyatsoonekwa ne catheterization.

Nezvemushonga wako, unogona kushandura kubva kuCaraten (Cardivolol) kuenda kuNebilet (Nebivolol). Iyo yekupedzisira haina dilate midziyo.
Iyo Vastarel (Trimetazidine) zvakare inonzwika isingachashandi kwandiri. Uyu ndiwo mushonga weAngina Pectoris.
3 × 40 mg Seguril pazuva inoratidzika zvishoma uye uyezve hairatidzi kushanda zvakakwana. Unogona kuisanganisa neSpironolactone. Izvi zvakare zvakanaka kune electrolyte (K uye Na) chiyero.

Zvisinei, mumaonero angu, kuongorora kwemwoyo kwakazara, kusanganisira catheterization, kunodiwa. Kuchinja kwemishonga kana kumwe kurapa kunogona kuitwa zvichienderana nemhedzisiro.
Hazvizove nyore. Zvakawanda zvinoenderana nachiremba.

Rombo rakanaka uye kubudirira,

Ndakaperera,

Dr. Maarten