Asians and high blood pressure

[nayr69sg]

Since , there is a lot of folks here quite scared to shit about BP n diabetic and each expanding their craps , let me give my 2 cents worth ...talking about HbA1c or Haemoglobin A1 c , is a Long term reading of your sugar level say over 3 months sort of an average rather than a instantaneous done by glucometers ,,,this is what our resident doctor @ nayr69sg recommended as the golden rule ? But is it ? Why ? Suppose , your sugar level swings extremely from say 20 at upper and 3 at nights , your average will still be pretty good by HbAc1 done since it’s an average thingy but escapes your terrible terrible health situation ...so an instantaneous glucometer tests done at the right time gives you a far more better readings , like one before your breakfast and others just before your meal and 1 just before you go to sleep and better if 1 done at 3 or 4 AM ... but docs don’t have the time to monitor you like this unless you are hospitalised ...

and suppose if you go to the doctor very dehydrated and your blood pressure reading is rather good , is that any good ? Nope, certainly not because doctors these days do not divthings like what older doctors did .,,how many of you remember the olden days when your family doctor who did house calls ask you to stick your tongue out ? That’s checking your dehydration , simply not done by young doctors anymore ...so older doctors also checked the state of your body condition along with BP and others ...whreas young Doctors totally relies on machine readings

myself have been hospitalised and one thing I observed was the team of Doctors who visit you in the morning almost entirely look at the patient’s record in the computer than the patient himself , a total and over reliance on machine readings and not the state of how the patient is as of that time ...take note @ nayr69sg

Technology has changed medicine.

We still train in clinical skills. But nobody relies on that anymore.

Used to be neurologists would use examination to identify the level of neurological deficit. Which cranial nerve? Then map to which part of brain? Which nucleus?

But nobody relies on that now. They do CT scan. MRI.

And why wouldn't they? The technology is there.

You prefer the doctor not to?

Nowadays the soft touch is wayang. Patient like it of course. But they will still say eh no scan? You not sending me for scan? No blood test?

How many here would trust doctor purely on their superb clinical skills? The days of William Osler over already.

Medicine is dead.

Soon it will be robots doing the job.

 

[nayr69sg]

Yes Dr.
Atrial Fibrillation.

Yes, on Warfarin too.

Yes I guessed cos you on Amiodarone.

So some kind of arrhythmia. More common is AF.

 

[bonds]

Yes I guessed cos you on Amiodarone.

So some kind of arrhythmia. More common is AF.

Correct Dr.

 

[Nice-Gook]

HBA1c is located hemoglobin.

We liken it to average glucose it is a different measure altogether.

It is called improvements in technology and science.

If you can do just 1 reading and test every
3 to 4 months versus daily readings.....

Sure you can still do daily and get by which is probably what they do in the 3rd world rural areas with no labs.

Like I said everyone wants to do what they want.

Which is why I have gone to medical cannabis.

When the shove becomes a push , than I always on a professional side ...in this instance you and not me , a professional

having said that , you should elaborate , my understanding of HbA1 is a lab test measurements of certain residue in blood that gives you your glucose AVERAGE reading , an I wrong in that ?

it’s still an average over a period , wrong or right ?

if I indeed can learn something in this discussion , why not ? I am all ears

 

[tanwahtiu]

Want to have instant high blood.

Take half panadol with a can of coke.

 

[nayr69sg]

When the shove becomes a push , than I always on a professional side ...in this instance you and not me , a professional

having said that , you should elaborate , my understanding of HbA1 is a lab test measurements of certain residue in blood that gives you your glucose AVERAGE reading , an I wrong in that ?

it’s still an average over a period , wrong or right ?

if I indeed can learn something in this discussion , why not ? I am all ears

Glycated hemoglobin. Percentage of hemoglobin that have glucose molecule attached to it.

Why is it only done every 120 days? And why does it only change every 120 days? Because that's the life span of a red blood cell. Hence those glycated hemoglobin molecules stay in RBCs for 120 days.

Do you call that a "residue"? Perhaps.

It is not really an average glucose reading directly. Indirect yes.

The more glucose the RBCs are swimming around in the more of them % will be glycated.

Think of you swimming in a pool of shit. The more shit the more likely people coming out of pool will be covered with shit. Less shit then less people.

People live 80 years? So that number changes every 80 years. Something like that lah.

 

[Nice-Gook]

Technology has changed medicine.

We still train in clinical skills. But nobody relies on that anymore.

Used to be neurologists would use examination to identify the level of neurological deficit. Which cranial nerve? Then map to which part of brain? Which nucleus?

But nobody relies on that now. They do CT scan. MRI.

And why wouldn't they? The technology is there.

You prefer the doctor not to?

Nowadays the soft touch is wayang. Patient like it of course. But they will still say eh no scan? You not sending me for scan? No blood test?

How many here would trust doctor purely on their superb clinical skills? The days of William Osler over already.

Medicine is dead.

Soon it will be robots doing the job.

Please don’t be over presumptuous here doc

if I had married earlier I would have been old enough to be your father , by which I am not touting my age factor alone , but having been around 60 odd countries and having lived in a dozen I am indeed quite exposed to various things in life

I had no way pooed pooed technology in anything , let alone medicine , ...in the days of my father before 50s n 60s I had observed how he use to take his urine in a test tube and boil it before injecting himself with the older version of insulin ...today it’s done just in a moment

but what my grouses are is how modern medicine is practiced legally , and I don’t fault the medical practitioners either ...in the olden days family Doctors were practically part of your family , they know you and your family history as well as how you live ...today the cost of living makes that impossible ...in the very short time of consultation the medical practitioners spent with you a decision must be made and that too not to entangling themselves into legal traps ...so it becomes necessary to use the very machine reading to play safe and practice safe medicine ...it’s actually the predicament of modernity itself ..

 

[Nice-Gook]

Glycated hemoglobin. Percentage of hemoglobin that have glucose molecule attached to it.

Why is it only done every 120 days? And why does it only change every 120 days? Because that's the life span of a red blood cell. Hence those glycated hemoglobin molecules stay in RBCs for 120 days.

Do you call that a "residue"? Perhaps.

It is not really an average glucose reading directly. Indirect yes.

The more glucose the RBCs are swimming around in the more of them % will be glycated.

Think of you swimming in a pool of shit. The more shit the more likely people coming out of pool will be covered with shit. Less shit then less people.

People live 80 years? So that number changes every 80 years. Something like that lah.

Nonetheless an average , right ?

 

[nayr69sg]

Please don’t be over presumptuous here doc

if I had married earlier I would have been old enough to be your father , by which I am not touting my age factor alone , but having been around 60 odd countries and having lived in a dozen I am indeed quite exposed to various things in life

I had no way pooed pooed technology in anything , let alone medicine , ...in the days of my father before 50s n 60s I had observed how he use to take his urine in a test tube and boil it before injecting himself with the older version of insulin ...today it’s done just in a moment

but what my grouses are is how modern medicine is practiced legally , and I don’t fault the medical practitioners either ...in the olden days family Doctors were practically part of your family , they know you and your family history as well as how you live ...today the cost of living makes that impossible ...in the very short time of consultation the medical practitioners spent with you a decision must be made and that too not to entangling themselves into legal traps ...so it becomes necessary to use the very machine reading to play safe and practice safe medicine ...it’s actually the predicament of modernity itself ..

Not disrespecting you sir.

I know you are my father's cohort.

I agree with you.

Times have changed. During the 70s and 80s patients listen to drs.

From the late 90s onwards patients are autonomous now. They decide.

It has made things harder for practitioners.

The relationship between dr and patients has changed too.

I personally view every patient as a potential complaint. How to view patients as friends? Cannot anymore.

Singapore is a bit different cos SMC does not disallow drs to be friends with patients. In Canada cannot.

All patient have to be strangers.

I was not trained in sg to think this way. We all trained to be caring drs. But the reality is the system and SMC does not see it that way. Patients complain all the time and dr is always wrong.

So best to follow what patient want. Not about dr anymore. We are just service provider. You want what we do. Like car mechanic. You dowan change the radiator? Ok pack up give you back the car.

 

[nayr69sg]

Nonetheless an average , right ?

Agreed.

But this average is simply done 3 times a year.

Actually at polyclinic patients are happy with it. Only check 3 times a year. And urine albumin micro album ratio twice a year. Ok lah. Cost is flat fee.

Problem is the private clinics. When I was a GP the HBA1c cost $35!

Most say dowan lah. And I dont blame them.

Medicine is dead lah. Nobody want to pay for medical costs.

 

[Nice-Gook]

Not disrespecting you sir.

I know you are my father's cohort.

I agree with you.

Times have changed. During the 70s and 80s patients listen to drs.

From the late 90s onwards patients are autonomous now. They decide.

It has made things harder for practitioners.

The relationship between dr and patients has changed too.

I personally view every patient as a potential complaint. How to view patients as friends? Cannot anymore.

Singapore is a bit different cos SMC does not disallow drs to be friends with patients. In Canada cannot.

All patient have to be strangers.

I was not trained in sg to think this way. We all trained to be caring drs. But the reality is the system and SMC does not see it that way. Patients complain all the time and dr is always wrong.

So best to follow what patient want. Not about dr anymore. We are just service provider. You want what we do. Like car mechanic. You dowan change the radiator? Ok pack up give you back the car.

It’s not only your profession even mine too , that’s the price you and I pay for modernity , but me think it’s an improvement non the less

There is an ancient chinese wisdom , the emperor asked the wise men to come with a phrase that stand the time and ever memorial ...after much deliberation , they came with this phrases, ‘ this too will change ‘

 

[nayr69sg]

Please don’t be over presumptuous here doc

if I had married earlier I would have been old enough to be your father , by which I am not touting my age factor alone , but having been around 60 odd countries and having lived in a dozen I am indeed quite exposed to various things in life

I had no way pooed pooed technology in anything , let alone medicine , ...in the days of my father before 50s n 60s I had observed how he use to take his urine in a test tube and boil it before injecting himself with the older version of insulin ...today it’s done just in a moment

but what my grouses are is how modern medicine is practiced legally , and I don’t fault the medical practitioners either ...in the olden days family Doctors were practically part of your family , they know you and your family history as well as how you live ...today the cost of living makes that impossible ...in the very short time of consultation the medical practitioners spent with you a decision must be made and that too not to entangling themselves into legal traps ...so it becomes necessary to use the very machine reading to play safe and practice safe medicine ...it’s actually the predicament of modernity itself ..

I was told this by an old timer.

You follow rules and guidelines do what you know is best for patient.....if the patient not happy with that they complain you still Answer then get told you need to improve communication skill.

You follow what patient want dotn follow rules and guidelines maybe even do something you know is not so good for the patient but patient want and is happy.....nothing will happen. Patient wont complain. In fact they love you. Happy. In fact if something go wrong they will blame the hospital or other drs.

So go figure. I have seen that this is true.

Problem for me is I have conscience. I feel bad if I dont do the right thing. But I have slowly begun to do the difficult till it becomes comfortable.

 

[Hypocrite-The]

Even that too is a fallacy , I mean the good and bad oil thingy ...do you know Indonesians by survey has the healthiest heart , and they consume everything and anything coconut including its oil but science says coconut oil very belly bad for you

Its hydrogenated oil tat is bad. Pure coconut oil is ok. Cold press coconut oil also ok. At 1 time margarine etc was promoted as good because the inventors needed to sell the product. Now margarine etc is proven to b bad..the best assumption is everything process is bad n hydrogenated oils is bad. Work on tat baseline can oreadi

 

[Nice-Gook]

Its hydrogenated oil tat is bad. Pure coconut oil is ok. Cold press coconut oil also ok. At 1 time margarine etc was promoted as good because the inventors needed to sell the product. Now margarine etc is proven to b bad..the best assumption is everything process is bad n hydrogenated oils is bad. Work on tat baseline can oreadi

you are absolutely right ,I say and let me add ...even in coconut oil ,oil derived from copra is bad ...in fact ever since the industrial revolution oil is derived mainly by hot pressed and filtered ,that's bad ...whreas our fore fathers oil were mainly derived by cold pressing and that's good ,no matter what oil that was

 

[nayr69sg]

Anything Primary ....eg Primary Hypertension means we dotn know exactly what is causing it.

We do know how we can lower Blood Pressure. But why is it high? Many factors no one reason.

 

[Nice-Gook]

Anything Primary ....eg Primary Hypertension means we dotn know exactly what is causing it.

We do know how we can lower Blood Pressure. But why is it high? Many factors no one reason.

but i reckon our stress level and as a factor aggregates it too

 

[glockman]

cumsommez to your cœur’s content.
View attachment 92308

Oh I love bak pock! Shiok when eaten with almost anything.

 

[zhihau]

Oh I love bak pock! Shiok when eaten with almost anything.

pig’s blood curdle and duck’s blood curdle can’t be found in Singapore too!

 

[glockman]

pig’s blood curdle and duck’s blood curdle can’t be found in Singapore too!

Yep, but that's fine with me. I don't really like them. They make me feel queasy.

 

[glockman]

Anything Primary ....eg Primary Hypertension means we dotn know exactly what is causing it.

We do know how we can lower Blood Pressure. But why is it high? Many factors no one reason.

Stress, DNA and lifestyle choices like smoking, drinking. Oh wait, I just described myself.