Tuesday, October 7, 2008

"M" word!


Yesterday it was mission, today its possibly that other "m" word! I went to the Doctor yesterday afternoon. After a long discussion and me telling him all about T3 and my symptoms which are the same as Mariette Chippendall and her underactive thyroid - he looked at me quietly, let me finish my lecture in medicine and said, "That may be your problem, and we will test the T4 and T3 levels this time. How old are you? You do realise that your symptoms are also symptomatic of menopause!"

So, all my grand ideas of being able to get myself sorted out, have taken a bit of a back seat until the results of the blood tests come back. Then he will decide how best to treat me! I felt a bit of a twit when I got home and thought about how I produced the book and rattled on about how GP's don't always diagnose thyroid problems correctly as its not something they work with every day - yarra, yarra, yarra! Hahaha! He took it quite well though and we did have a good laugh!

17 comments:

Anonymous said...

I am seeing Dr Megan (At Dr Bhana's offices) today at 4.

I hope it is not just a money making racket and that I won't be wasting money...

I found this letter online @:
http://www.physician.co.za/images/SEMDS%20Huisgenot%20Article2005.doc

FACULTY OF CONSULTING PHYSICIANS OF
SOUTH AFRICA

P.O. Box 2896 jakok@mweb.co.za
Alberton 1450 T) 011 907-8827/8
F) 011 907-9429



SEMDSA Committee
P.O. Box 783155
Sandton
2146

Dear Colleagues,

Re: Huisgenoot / YOU magazine articles on Thyroid disease – 24 March 2005 & 10 February 2005


I would like to respond to the content and tone of these articles after receiving numerous calls from colleagues and patients alike. I include a copy of the Huisgenoot and YOU articles for your perusal. This is sensationalist journalism at its worst as it seeks to simplify complex medical problems by lumping all together as “mysterious” thyroid disease and then creating an expectation from the patients point of view of an unrealistic, dramatic cure for all their ills. I am not surprised that Dr. Bhana’s rooms were inundated with calls following these articles.

I take exception on behalf of the Specialist Physicians and also General Practitioners, who have been lambasted by their patients for “missing the diagnosis” and “inadequate treatment” and for failing to refer to the “few” Endocrinologists able to treat this mysterious illness. As I am sure you would agree not every obese female has thyroid disease!

Treatment with Diotroxin and Tertroxin as far as my knowledge goes, would not be indicated for long term replacement therapy if Eltroxin is adequately correcting the TSH/T4/T3 levels. I would also like to know how Dr. Bhana arrived at the prevalence figures quoted in the article? (800 000 – 1 million of thyroid patients in SA).

Does this type of medical misinformation pass through SEMDSA before publication? I am sure it does not, otherwise the problem could be avoided.

I have an additional personal problem with the management of a cardiac patient I recently had occasion to see. This gentleman, Mr. Harase, had a CABG approximately three weeks before seeing me and was assessed by Dr. Bhana thereafter. On the basis of a fasting insulin level this patient (with a fasting glucose level of 5,2) was placed on Metformin and told he was at risk of Diabetes and required this treatment. He was told by Dr. Bhana that he believed all patients with high insulin levels should be treated as diabetic and that the scientific literature had not yet sanctioned this because they lagged behind.

I find this quite a sweeping statement especially from an Endocrinologist. The patient subsequently had severe side effects to the Metformin but when he contacted Dr. Bhana’s rooms, he was apparently told to continue taking the medication for 3 – 4 weeks. He ended up being referred to myself by his general practitioner and I discontinued the treatment as I felt it was not indicated. Is it now policy to use Metformin for a normal glucose and does a fasting level diagnose diabetes?

He also had numerous blood tests performed at tremendous cost e.g. Somatomedin C, Cancer Markers and a highly sensitive CRP when he just had a CABG. This is just plain bad medicine and I think require action by SEMDSA from the endocrine point of view especially.

I await your urgent reply.

Thank you,

Yours sincerely


Dr. Adri Kok
Chairperson FCPSA
MBBCh (Rand) Dip PEC (SA) FCP (SA) MMed (Int. Med)
P.K. No. 1805622

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