ความคิดเห็นที่ 13
K. ThaiAng- ka...let me borrow this kratoo to say something since someone makes it personal to them. I am sick of this BS from the person. Anything I said is a general knowledge and a common sense in health care practice. I will not change any of my comment because I don't have to make myself look pathetic and victimized or have to make myself look good. Some certain person always thinks that I talked about them. I said many time before that the person is nothing to me. This is not the first time when I say something on this webboard and the person make it personal  I have never mentioned any name in any of my comments now or in the past, the person just assumed that "IT ALL ABOUT ME...ME...ME. SHE MUST TALK ABOUT ME". I hardly read that person comment because it is always long, pointless and many time just like reading a search engine. .. "Kin Poon Ron Tong" must be true. Needless to say, many long time members know well what is actually going on outside pantip. I should have followed their wise advice to "avoid" sharing kratoo with the person and maybe next time I have to put disclaimer under my every comments that this not about you 
Now back to your question ka. Ha..ha..first of all I don't feel "ขัดใจ" ka. I'm not a stroke expert and never claim that I have extensive experience though I take care of that kind of patient every day. If you have read many comments of mine on this webboard, I'm very open to constructive opinion and very straight forward. If I know something I say it, but if I don't...I'll not say a word. I'll not give wrong information and try to be an expert on things that I don't have an idea. I say how I feel openly and don't pretend to be nice. I will not send evil thing about other people in the paper columns, email, PM or on the webboard. I have never said how many people I have helped because I don't expect any praise or anything in return. I know in my heart that I help them and don't have to announce it all over the web and PM.
Let me address again for my earlier comments, I talked in general term that people should not give any medical advice over the internet if they are not licensed. I am fine with sharing infor but when people start represent themselves as expert...in my opinion it is wrong ka. (Again, I talk in general term if someone feel offeded..it is not my problem.) This is not the first time I said it either on pantip or other Nursing and medical webboard that I am a member and I have never had a problem ...why this time it become such a problem. This the way that medical and health care professional practice and learn here...we do not give advice or sharing information we don't know or have minimum knowledge about it. If we are going to give any referral or websites, we have to reviewed ourselves first that information is correct and current.
Also internet is not the best resource to find the information about disease
as I said before many website are not reviewed by medical and health care professional...the information can be incorrect and it does more harm than good. Many hospital and medical center or public/university library have handout and books that have information about the disease that more current and accurate.
I still insist the second opinions should come from people who know or have reviewed your uncle the case. Different patient will have different symptom even though it is the same disease. Not every stroke patient is under the care of Neurologist either...most stroke patients is under the care of internalist/family doctor who will oversee every aspect of patient health and disease not just the stroke. If you feel that your uncle need to see one, it is up to you ka. Just requests the referal from your uncle doctor.
Now, I understand why you want to know MRI result. I agree that the doctor should not brush you off and should give more information to your uncle about his condition. You need to know though most doctors will not discuss the case with relative if the patient is alert and oriented. Only your uncle or his wife should be the one who ask the doctor ka. I cant say whether or not your uncle got MRI done because I didnt work there. If you want to know whether or not your uncle received the treatment that he deserved and the doctor refuse to tell you, your uncle can request to review the chart and the treatment record and request the doctor to explain it. Every hospital have to follow the patient bill of right and one of the thing said patient have the right to know their own treatment ka.
May I explain something about stroke treatment na ka. MRI or CT result right now is not that important to treat the patient post stroke. MRI and CT brain is the tool to diagnose the stroke... identify the origin and kind of stroke to choose the right treatment when patient first come to ED. Let say, if your uncle first come to ED..then it is important to do Brain MRI or CT because it can effect choice of his treatment..and whether or not the clot buster medication (tPA) needed to be order. If he have hemorrhagic stroke..of course clot buster is not an option because he will bleed more in the brain and other treatment need to be ordered. As khun. J said time is important to treat stroke early, the faster the treatment...the less damage to patient health and well being.
For post stroke patient, the important thing to do is rehabilitation, physical theraphy and prevention of another stroke. Many stroke patients have some source of physical disability such as trouble speaking, walking etc. So rehab and physical therapy is important so the patient can be their own self faster and have less psychological effect. Family is important but the patient themselves needs to learn to take care of themselves as well. Controlling blood pressure, weight and stress level is important. That is why the doctor said it is the key to treat the present symptom. If your uncle still have high BP or overweight or high level of stress...he have more chance to have another stroke or TIA
no MRI result would not help. If your uncle shows another sign of stroke, then he will needs to have another MRI or CT to confirm it. Doctors, Nurse Practitioner or Physician Assistant are trained to use lab and radiology result as tools to diagnose and design the treatment...but the patient presenting and current symptom is the key...not just stroke treatment but for every diseases.
I didn't say the doctors always right because I know many time they are wrong since I work with them everyday. I didn't say either that patient have no right to know their treatment. For me, every patient of mine knows their treatments and options
risk and benefit of treatment. But I will not discuss it with relative unless I got permission from the patient themselves because it is confidentiality issue.
Thank you for sharing the article ka. It is a sadly truth. I have heard about it before that some hospitals and doctors refuse to do some certain diagnostic or procedure because they want to keep the cost down. It is a long term problem of US health care system...not just MRI or specialist on call...but everything ka. Many hospital trying to make the most profit without thinking about patient care. Especially if you go to small rural hospital that doesn't have many beds. They are will not equipped to handle major emergency. Many patients either airlift or quickly send to major hospital or medical center nearby. Let me give you another sample, a C-section, now many small OBGYN practice group refuse to do it because of high cost of malpractice insurance...if the patient need it, they will send the patient to another OBGYN. There are lots of problem in the health care system ka..if I have to tell all, it will be never ending story I'm a very fortunate that medical center that I work for and trained have state-of-art equipment and nationally acclaimed doctors and health care professional. Besides we are a stroke and cardiac center in the bay area. So, we don't have to face that kind of problem.
Sorry na ka, it is quite long nad I have to type in English. My thai type writhing is terrible. I hope I answer your question and doubt na ka. Anything else you wonder, let me know ka.
จากคุณ :
SFbay
- [
26 มี.ค. 51 02:07:13
A:75.7.24.115 X: TicketID:164020
]
|
|
|
FYI: Neurology- Neurologists 
FYI: Neurologist
คุณ ThaiAng- 
