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戶外大夫專欄 Outdoor Doctor Forum:
| By j on Wednesday, November 28, 2007 - 3:28 am: Edit
what should we take care after the
percutaneous coronary artery balloon dilatation?
| By Outdoor Doctor (Doctor) on Monday, September 03, 2007 - 10:44 am: Edit
Quite often, the cause of Eczema 濕疹 is unknown. Sometimes, it may be due to the contact of some irritants. Contact with some plants in the outdoor may lead to skin pruritus or even an eczema attack (the location of the eczema should be the area your skin had contact with the plant). You should learn about it from your experience.
Having eczema does not mean that you should stop hiking. However, long course of Prednisolone may lead to weakened immune system and osteoporosis.
Try to keep your body well ventilated during hiking and don't scratch the skin. Skin abrasions can allow the environmental bacteria to go to the body more easily.
| By 煩人 on Friday, July 27, 2007 - 11:11 pm: Edit
prednisolone 5mg(A) 每日二次每次三粒﹐是否藥力太高﹐我很怕有副作用﹐要連服一星期﹐及一隻抗生素﹐
klacid(clarithromycn) 250mg(A) 連吃一星期﹐現在連山都不能行﹐今次染到濕疹不知是否大熱天行山及穿密林有關？而本人又是一毎易患濕疹及皮膚敏感的人﹐請醫生多多賜教！謝謝。問藥的影響及可否行山。
| By 煩人 (126.96.36.199) on Monday, October 18, 2004 - 11:31 pm: Edit
| By abc (188.8.131.52) on Tuesday, October 19, 2004 - 4:09 pm: Edit
You should see a doctor (specializing in ear, nose and throat) for proper checkup. The essential thing is to rule out any disease inside the nose. You also require blood tests including complete blood count and clotting profile.
If bleeding occurs, you should sit/stand up and squeeze the nose for several minutes by using your thumb and index finger. This is a simple method to control the bleeding.
| By 煩人 (184.108.40.206) on Wednesday, October 20, 2004 - 10:19 pm: Edit
十分謝謝ABC 及Outdoor Doctor 君﹐你們的意見我會參考﹐尤其是Outdoor Doctor 君的意見很專業﹐很有幫助。
Make sure that PT, APTT (clotting profile) are also normal.
Make sure that you don't have any abnormal solid lesion inside the nose (such as nasopharyngeal cancer). Such lesion can be detected by endoscopy performed by an ear-nose-throat (ENT) doctor. You should see the ENT doctor again for reassessment.
| By 煩人 (220.127.116.11) on Friday, November 12, 2004 - 10:35 pm: Edit
上星期我己再看 E.N.T. 及抽組織化驗 是Lymphoid hyperplasia ﹐APTT 為31.H 而 PT 就正常﹐同時發現有血管擴張也一起電了。等報告那刻心情真的磨人﹐不過這種心情﹐一生人中也不知試過多少次了﹐祗有認命﹐及無奈。見Doctor 先前提點今有結果也應講聲。
A sense of peace is more important than money!
If you have serious ischemic heart disease (冠心病), you must avoid heavy exercise. Heavy exercise can lead to a severe heart attack. You should take aspirin (亞士匹靈) unless you have peptic ulcer/ gut bleeding / allergic reaction to the drug. It is one of the most important drugs for prevention of severe heart attack. Please let me know more about your health status:
How old are you?
Have you had any chest pain?
How did you know that you have ischemic heart disease? (by ECG? by treadmill exercise test?)
Do you have hypertension, high blood cholesterol level, diabetes mellitus (high blood glucose level) and smoking habit?
| By 煩人 (18.104.22.168) on Thursday, March 31, 2005 - 11:38 pm: Edit
很多謝你的解答﹐讓我詳細述說吧﹐去年11月我在一私家醫院做了一個踏板心電圖﹐運動到第三速度時發覺心臟血管過血有問題﹐結果是報告出時醫生吿知。胆固醇6.8 甘油三脂0.7 LDL 3.7 HDL 2.2 醫生說要小心飲食﹐恐防心臟有事﹐見了營養師﹐此事告一段落。我經醫生介紹再到政府醫院重新看醫生。此後幾個月我沒有把這事放心上﹐12月時還湊熱鬧去行樂善三十公里。和行山活動。今年3月11 日報告出了﹐結果與在私家醫院一樣﹐因此醫生就著我做我告訴你的一切事情了。到六月再看心臟科醫生。我一向都不覺有胸痛﹐亦沒有高血壓﹐沒糖尿病﹐沒吸煙﹐血糖正常﹐祇是高血脂﹐但在廿多年前當年廿多歲時‥試過一次心口痛到暈了﹐住了一個星期醫院。也不覺醫生說我有心臟病﹐日後又沒翻發﹐不是今次有事也記不起。為什麽我不吃葯呢！是我個胃曾經試過潰瘍﹐雖然醫好了但還很抗拒吃有偒胃的葯。雖然連胃葯一起吃也都是抗拒。怕醫得頭來腳反根。我覺得自都好葯煲﹐真煩人一個﹐所以想聴聴醫生專業意見﹐十分感激﹐謝謝你。
1) Why did you do a treadmill exercise test?
2) Did you have any chest pain during the treadmill exercise test?
3) Did you have any chest pain during 樂善三十公里? Any chest pain during heavy exercise like long period of running or hiking?
4) Does your parent, brother or sister also have ischemic heart disease 冠心病?
5) What did the cardiologist 心臟科醫生 say? Did the cardiologist suggest you to do further investigation?
6) You are less than 50 years old, aren't you?
| By 煩人 (22.214.171.124) on Thursday, April 07, 2005 - 12:20 am: Edit
１． 是一個身體檢查套餐﹐內包括了•( 因常覺身體不適﹐所以做一個全身檢查。)
３． 否﹐未試過長跑運動。上山時會覺辛苦﹐相信很多人都會這樣﹐未試過 chest pain。
５． 六月才正式見 cardiologist ﹐現在是醫院內科醫生叫我吃葯﹐相信他會問及心臟科醫生。才開葯給我的。
7. 請問 Outdoor Doctor 我是否一定要吃葯﹐中途可否停葯？可否繼續行山？謝謝。
What kind of 身體不適 did you have?
It is not advisable to perform a treadmill test if one does not have a) any symptom suggestive of heart disease, b) family history of heart disease or c) risk factor for heart disease.
The reason is that an unnecessary treadmill test can give rise to a false positive result (i.e. an abnormal treadmill result in a person without ischemic heart disease).
If you have the treadmill report, please state the findings (including how much mm ST depression).
I doubt whether you really have ischemic heart disease.
| By 煩人 (126.96.36.199) on Tuesday, April 12, 2005 - 12:01 am: Edit
我都希望如 Doctor 所講未盡可信﹐但2間醫院都相同﹐那又可否當真呢！
Exercise 3, speed 3.4mph, grade 14.0%
Peak EX, HR156pm, speed: 4.1mph grade 16.0%
(Procedure : Bruce) (Exercise time : 10:21) (Maximum heart Rate Attained : 57bpm)
(92% Max predicted 170bpm) (Maximum BP : 160/75)
(Maximum workload attained : 12 mets) Reason for Termination : Fatigue
mainly upsloping ST segment depression seen during exercise, however there is IMM ST segment depression over V3-V4 leads at peak exercise prompt recovery no chest pain throughout test. Borderline positive treadmill test at high workload capacity—12 mets.for clinical correlation, unlikely to have significant coronary artery disease.
Based on your history and your treadmill result, I don't think you have ischemic heart disease.
The most accurate method to clarify your problem is by coronary angiogram. You can discuss it with your cardiologist.
If you don't have ischemic heart disease, there is no reason to stop hiking.
| By 煩人 (188.8.131.52) on Wednesday, April 13, 2005 - 11:55 pm: Edit
| By 煩人 (184.108.40.206) on Friday, July 08, 2005 - 12:49 am: Edit
六月尾己看過心臟科醫生﹐他說好難說有沒有事﹐給我十一月尾做一個「心臟核子掃描﹐十二月尾才覆診。」﹐如此一等又是半年。而且我亦怕有幅射﹐因此我為有在私家醫院照了一個磁共震﹐貴到肉都痛！報告出了說看不出有大毛病冠心病﹐反而三尖瓣有少許倒流﹐醫生說不算大問題﹐可不用理會﹐那就鬆了口氣。醫生還說磁共震祇有80 % 準﹐收費那樣貴都沒有100 % 準﹐真的很無奈。
Thallium scan 心臟核子掃描 is another way of detecting coronary artery ischemia. It is sometimes used when treadmill test gave equivocal result.
MRI imaging of the heart already reassure you that you don't have significant coronary artery problem.
Don't worry too much. A patient really getting coronary artery disease usually have chest pain during exercise (e.g. hiking). If you don't have such symptom and the MRI heart is unremarkable, the chance of having coronary artery disease is low. I think your private doctor should have also mentioned about that.
| By 煩人 on Tuesday, September 05, 2006 - 11:43 pm: Edit
The radiation exposure is acceptable. For cardiac catheterization, the diameter of the wound is similar to the diameter of a pencil.
Sometimes, percutaneous coronary artery balloon dilatation needs to be repeated several years after the first one (because re-narrowing of the coronary artery). If there is only 30% narrowing, a good diet control (reducing cholesterol, stop smoking) + drug treatment can prevent disease progression and avoid the necessity of having percutaneous coronary artery balloon dilatation.