Dr Chung /meds comments please

"bnd777" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

87 yr old female as previously posted

Suspicion that Arcoxia 60mg a day may be the reason for current uncontrollable BP (has been on it
for 2 months for pain of severe Osteoporosis/RA/OA that other painkillers do not touch )

Has been taking Atenolol 50mg Tritace 10mg Bendrofluazide 2.5mg and Plendil 2.5 mg was added 2
weeks ago

Has irritating dry tickly cough swollen ankles tired slow eyes watering (but also has cataracts )
noisy breathing/breathless

Comments welcome

Cataracts as well and still driving! see this for Arcoxia
irf.dkarcoxia.htmOpen ↗ Derek.

"bnd777" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

87 yr old female as previously posted

Suspicion that Arcoxia 60mg a day may be the reason for current uncontrollable BP (has been on it
for 2 months for pain of severe Osteoporosis/RA/OA that other painkillers do not touch )

Though I am not familiar with Arcoxia specifically, as a class, NSAIDs do make hypertension more
difficult to control. Would suggest you ask about narcotics or "alternative" methods of pain control
(acupuncture?)

Quoted message said:

Has been taking Atenolol 50mg

Atenolol is not a good beta blocker for the elderly who tend to have decreased renal function (it is
renally cleared). Would suggest you ask about a change to a non-renally metabolized beta-blocker.

Quoted message said:

Tritace 10mg

Given you describe what is likely an ACE inhibitor cough, this may not be a good choice either
especially if the cough is causing sleep deprivation, which can also make hypertension more labile
(difficult to control). Would suggest you ask about ARBs (angiotensin receptor blockers) as an
alternative.

Quoted message said:

Bendrofluazide 2.5mg

Thiazide diuretics are less effective in the elderly especially if there is decreased renal
function. Would suggest you ask about a change to loop diuretics.

Quoted message said:

and Plendil 2.5 mg was added 2 weeks ago

Calcium channel blockers can worsen edema. They may not even be necessary if the rest of her
medications were more "optimal."

Quoted message said:

Has irritating dry tickly cough swollen ankles tired slow eyes watering (but also has cataracts )
noisy breathing/breathless

Comments welcome

Hope my comments help.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message

news:<[email hidden]>...

Quoted message said:

Quoted message said:

87 yr old female as previously posted

Suspicion that Arcoxia 60mg a day may be the reason for current uncontrollable BP (has been on
it for 2 months for pain of severe Osteoporosis/RA/OA that other painkillers do not touch )

Though I am not familiar with Arcoxia specifically, as a class, NSAIDs do make hypertension more
difficult to control. Would suggest you ask about narcotics or "alternative" methods of pain
control (acupuncture?)

Quoted message said:

Has been taking Atenolol 50mg

Atenolol is not a good beta blocker for the elderly who tend to have decreased renal function (it
is renally cleared). Would suggest you ask about a change to a non-renally metabolized beta-
blocker.

Quoted message said:

Tritace 10mg

Given you describe what is likely an ACE inhibitor cough, this may not be a good choice either
especially if the cough is causing sleep deprivation, which can also make hypertension more labile
(difficult to control). Would suggest you ask about ARBs (angiotensin receptor blockers) as an
alternative.

Quoted message said:

Bendrofluazide 2.5mg

Thiazide diuretics are less effective in the elderly especially if there is decreased renal
function. Would suggest you ask about a change to loop diuretics.

Quoted message said:

and Plendil 2.5 mg was added 2 weeks ago

Calcium channel blockers can worsen edema. They may not even be necessary if the rest of her
medications were more "optimal."

Quoted message said:

Has irritating dry tickly cough swollen ankles tired slow eyes watering (but also has cataracts
) noisy breathing/breathless

Comments welcome

Hope my comments help.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

They sure explain a lot but to get them changed to what you suggest would mean sending her doctors
back to med school !!!!!!!!!!!!!

"Derek F" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

87 yr old female as previously posted

Suspicion that Arcoxia 60mg a day may be the reason for current uncontrollable BP (has been on
it for 2 months for pain of severe Osteoporosis/RA/OA that other painkillers do not touch )

Has been taking Atenolol 50mg Tritace 10mg Bendrofluazide 2.5mg and Plendil 2.5 mg was added 2
weeks ago

Has irritating dry tickly cough swollen ankles tired slow eyes watering (but also has cataracts
) noisy breathing/breathless

Comments welcome

Cataracts as well and still driving! see this for Arcoxia
irf.dkarcoxia.htmOpen ↗ Derek.

My sentiments precisly .........but as i said before if Opthalmologists and doctors in the UK are
not required to report the matter it makes it hell for concerned friends and family
.........because blame will be thrown on them by the patient who simply will not see it as in the
wider public interest

"bnd777" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message

news:<[email hidden]>...

Quoted message said:

Quoted message said:

87 yr old female as previously posted

Suspicion that Arcoxia 60mg a day may be the reason for current uncontrollable BP (has been on
it for 2 months for pain of severe Osteoporosis/RA/OA that other painkillers do not touch )

Though I am not familiar with Arcoxia specifically, as a class, NSAIDs do make hypertension more
difficult to control. Would suggest you ask about narcotics or "alternative" methods of pain
control (acupuncture?)

Quoted message said:

Has been taking Atenolol 50mg

Atenolol is not a good beta blocker for the elderly who tend to have decreased renal function
(it is renally cleared). Would suggest you ask about a change to a non-renally metabolized beta-
blocker.

Quoted message said:

Tritace 10mg

Given you describe what is likely an ACE inhibitor cough, this may not be a good choice either
especially if the cough is causing sleep deprivation, which can also make hypertension more
labile (difficult to control). Would suggest you ask about ARBs (angiotensin receptor blockers)
as an alternative.

Quoted message said:

Bendrofluazide 2.5mg

Thiazide diuretics are less effective in the elderly especially if there is decreased renal
function. Would suggest you ask about a change to loop diuretics.

Quoted message said:

and Plendil 2.5 mg was added 2 weeks ago

Calcium channel blockers can worsen edema. They may not even be necessary if the rest of her
medications were more "optimal."

Quoted message said:

Has irritating dry tickly cough swollen ankles tired slow eyes watering (but also has
cataracts ) noisy breathing/breathless

Comments welcome

Hope my comments help.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

They sure explain a lot but to get them changed to what you suggest would mean sending her doctors
back to med school !!!!!!!!!!!!!

That shouldn't be necessary. Having them read this should help them rethink things.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message

news:<[email hidden]>...

Quoted message said:

Quoted message said:

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message

news:<[email hidden]>...

Quoted message said:

> 87 yr old female as previously posted
>
> Suspicion that Arcoxia 60mg a day may be the reason for current uncontrollable BP (has been
> on it for 2 months for pain of severe Osteoporosis/RA/OA that other painkillers do not
> touch )

Though I am not familiar with Arcoxia specifically, as a class, NSAIDs do make hypertension
more difficult to control. Would suggest you ask about narcotics or "alternative" methods of
pain control (acupuncture?)

> Has been taking Atenolol 50mg

Atenolol is not a good beta blocker for the elderly who tend to have decreased renal function
(it is renally cleared). Would suggest you ask about a change to a non-renally metabolized beta-
blocker.

> Tritace 10mg

Given you describe what is likely an ACE inhibitor cough, this may not be a good choice either
especially if the cough is causing sleep deprivation, which can also make hypertension more
labile (difficult to control). Would suggest you ask about ARBs (angiotensin receptor
blockers) as an alternative.

> Bendrofluazide 2.5mg

Thiazide diuretics are less effective in the elderly especially if there is decreased renal
function. Would suggest you ask about a change to loop diuretics.

> and Plendil 2.5 mg was added 2 weeks ago

Calcium channel blockers can worsen edema. They may not even be necessary if the rest of her
medications were more "optimal."

> Has irritating dry tickly cough swollen ankles tired slow eyes watering (but also has
> cataracts ) noisy breathing/breathless
>
> Comments welcome

Hope my comments help.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

They sure explain a lot but to get them changed to what you suggest

would

Quoted message said:

Quoted message said:

mean sending her doctors back to med school !!!!!!!!!!!!!

That shouldn't be necessary. Having them read this should help them

rethink things.

Quoted message said:

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

In the UK if you dare go to your doctors with anything printed off the internet they show you the
door !!!!!!!!!!!!

Doctors and Specialists in the UK often never ever update their knowledge from the day they left
medical school

BTW ........Arcoxia is a Cox2 inhibitor which is not really a NSAIDs but it certainly does have the
side effect listed of rare cause of Hypertension As no other NSAIDs touch the pain and difficulty
she suffers due to collapsed spine from osteoporosis and it took 9 months of waiting to even see the
specialist who prescribed Arcoxia there will be little point trying to get any meds changes

I am very grateful for your help and astounded by your depth of knowledge ......seems our doctors
need to go back to med school fast

"bnd777" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

In the UK if you dare go to your doctors with anything printed off the internet they show you the
door !!!!!!!!!!!!

Is that true (others from the UK should chime in here) ?

Quoted message said:

Doctors and Specialists in the UK often never ever update their knowledge from the day they left
medical school

Really? No continuing medical education (CME) or recertification requirements?

Quoted message said:

BTW ........Arcoxia is a Cox2 inhibitor which is not really a NSAIDs

Actually, Cox2 inhibitors are still NSAIDs.

Quoted message said:

but it certainly does have the side effect listed of rare cause of Hypertension As no other NSAIDs
touch the pain and difficulty she suffers due to collapsed spine from osteoporosis and it took 9
months of waiting to even see the specialist who prescribed Arcoxia there will be little point
trying to get any meds changes

Would still recommend an unconventional approach (e.g. acupuncture, Tai Chi, meditation,
chiropractic manipulation etc) since there seems to be an intolerance for NSAIDs.

Quoted message said:

I am very grateful for your help and astounded by your depth of knowledge

You are welcome :-) May my depth of knowledge bring glory to God.

Quoted message said:

......seems our doctors need to go back to med school fast

Why don't the citizens of the UK should ask for change?

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message

news:<[email hidden]>...

Quoted message said:

Quoted message said:

In the UK if you dare go to your doctors with anything printed off the internet they show you
the door !!!!!!!!!!!!

Is that true (others from the UK should chime in here) ?

Quoted message said:

Doctors and Specialists in the UK often never ever update their

knowledge

Quoted message said:

Quoted message said:

from the day they left medical school

Really? No continuing medical education (CME) or recertification requirements?

Quoted message said:

BTW ........Arcoxia is a Cox2 inhibitor which is not really a NSAIDs

Actually, Cox2 inhibitors are still NSAIDs.

Quoted message said:

but it certainly does have the side effect listed of rare cause of Hypertension As no other
NSAIDs touch the pain and difficulty she suffers due to collapsed spine from osteoporosis and it
took 9 months of waiting to

even

Quoted message said:

Quoted message said:

see the specialist who prescribed Arcoxia there will be little point

trying

Quoted message said:

Quoted message said:

to get any meds changes

Would still recommend an unconventional approach (e.g. acupuncture, Tai Chi, meditation,
chiropractic manipulation etc) since there seems to be an intolerance for NSAIDs.

Quoted message said:

I am very grateful for your help and astounded by your depth of

knowledge

Quoted message said:

You are welcome :-) May my depth of knowledge bring glory to God.

Quoted message said:

......seems our doctors need to go back to med school fast

Why don't the citizens of the UK should ask for change?

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

Neither our doctors or our Health system or our government care one fig for what us citizens want
If our MPs were accountable like your Senators are things might change but with dictator Blair in
power foregt it

"bnd777" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message

news:<[email hidden]>...

Quoted message said:

Quoted message said:

In the UK if you dare go to your doctors with anything printed off the internet they show you
the door !!!!!!!!!!!!

Is that true (others from the UK should chime in here) ?

Quoted message said:

Doctors and Specialists in the UK often never ever update their

knowledge

Quoted message said:

Quoted message said:

from the day they left medical school

Really? No continuing medical education (CME) or recertification requirements?

Quoted message said:

BTW ........Arcoxia is a Cox2 inhibitor which is not really a NSAIDs

Actually, Cox2 inhibitors are still NSAIDs.

Quoted message said:

but it certainly does have the side effect listed of rare cause of

Hypertension

Quoted message said:

Quoted message said:

Quoted message said:

As no other NSAIDs touch the pain and difficulty she suffers due to collapsed spine from
osteoporosis and it took 9 months of waiting to

even

Quoted message said:

Quoted message said:

see the specialist who prescribed Arcoxia there will be little point

trying

Quoted message said:

Quoted message said:

to get any meds changes

Would still recommend an unconventional approach (e.g. acupuncture, Tai Chi, meditation,
chiropractic manipulation etc) since there seems to be an intolerance for NSAIDs.

Quoted message said:

I am very grateful for your help and astounded by your depth of

knowledge

Quoted message said:

You are welcome :-) May my depth of knowledge bring glory to God.

Quoted message said:

......seems our doctors need to go back to med school fast

Why don't the citizens of the UK should ask for change?

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

Neither our doctors or our Health system or our government care one fig

for

Quoted message said:

what us citizens want If our MPs were accountable like your Senators are things might change but
with dictator Blair in power foregt it

How long did Tony wait for treatment after his recent heart scare? A new clinic has been opened for
MP's in Victoria, where they are even allowed to give a false name if they have an embarrassing
condition. Derek.

"Derek F" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message

news:<[email hidden]>...

Quoted message said:

> In the UK if you dare go to your doctors with anything printed off

the

Quoted message said:

Quoted message said:

Quoted message said:

> internet they show you the door !!!!!!!!!!!!

Is that true (others from the UK should chime in here) ?

> Doctors and Specialists in the UK often never ever update their

knowledge

Quoted message said:

> from the day they left medical school

Really? No continuing medical education (CME) or recertification requirements?

> BTW ........Arcoxia is a Cox2 inhibitor which is not really a NSAIDs

Actually, Cox2 inhibitors are still NSAIDs.

> but it certainly does have the side effect listed of rare cause of

Hypertension

Quoted message said:

Quoted message said:

> As no other NSAIDs touch the pain and difficulty she suffers due to collapsed spine from
> osteoporosis and it took 9 months of waiting to

even

Quoted message said:

> see the specialist who prescribed Arcoxia there will be little point

trying

Quoted message said:

> to get any meds changes

Would still recommend an unconventional approach (e.g. acupuncture, Tai Chi, meditation,
chiropractic manipulation etc) since there seems to be an intolerance for NSAIDs.

> I am very grateful for your help and astounded by your depth of

knowledge

Quoted message said:

You are welcome :-) May my depth of knowledge bring glory to God.

> ......seems our doctors need to go back to med school fast

Why don't the citizens of the UK should ask for change?

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

Neither our doctors or our Health system or our government care one fig

for

Quoted message said:

what us citizens want If our MPs were accountable like your Senators are things might change

but

Quoted message said:

Quoted message said:

with dictator Blair in power foregt it

How long did Tony wait for treatment after his recent heart scare? A new clinic has been opened
for MP's in Victoria, where they are even allowed

to

Quoted message said:

give a false name if they have an embarrassing condition. Derek.

Next time we have a problem guess we need to find the "new clinic" and go in claiming to be MPs
!!!!!!!!!!!!!!

"bnd777" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"Derek F" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"bnd777" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...
> "bnd777" <[email hidden]> wrote in message
news:<[email hidden]>...
>
> > In the UK if you dare go to your doctors with anything printed off

the

Quoted message said:

Quoted message said:

> > internet they show you the door !!!!!!!!!!!!
>
> Is that true (others from the UK should chime in here) ?
>
> > Doctors and Specialists in the UK often never ever update their
knowledge
> > from the day they left medical school
>
> Really? No continuing medical education (CME) or recertification requirements?
>
> > BTW ........Arcoxia is a Cox2 inhibitor which is not really a

NSAIDs

Quoted message said:

Quoted message said:

Quoted message said:

>
> Actually, Cox2 inhibitors are still NSAIDs.
>
> > but it certainly does have the side effect listed of rare cause of

Hypertension

Quoted message said:

> > As no other NSAIDs touch the pain and difficulty she suffers due

to

Quoted message said:

Quoted message said:

Quoted message said:

> > collapsed spine from osteoporosis and it took 9 months of waiting

to

Quoted message said:

Quoted message said:

Quoted message said:

even
> > see the specialist who prescribed Arcoxia there will be little

point

Quoted message said:

Quoted message said:

Quoted message said:

trying
> > to get any meds changes
>
> Would still recommend an unconventional approach (e.g. acupuncture, Tai Chi, meditation,
> chiropractic manipulation etc) since there

seems

Quoted message said:

Quoted message said:

Quoted message said:

> to be an intolerance for NSAIDs.
>
> > I am very grateful for your help and astounded by your depth of
knowledge
>
> You are welcome :-) May my depth of knowledge bring glory to God.
>
> > ......seems our doctors need to go back to med school fast
>
> Why don't the citizens of the UK should ask for change?
>
> Humbly,
>
> Andrew
>
> --
> Dr. Andrew B. Chung, MD/PhD Board-certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

Neither our doctors or our Health system or our government care one

fig

Quoted message said:

Quoted message said:

for

Quoted message said:

what us citizens want If our MPs were accountable like your Senators are things might change

but

Quoted message said:

Quoted message said:

with dictator Blair in power foregt it

How long did Tony wait for treatment after his recent heart scare? A new clinic has been opened
for MP's in Victoria, where they are even allowed

to

Quoted message said:

give a false name if they have an embarrassing condition. Derek.

Next time we have a problem guess we need to find the "new clinic" and go

in

Quoted message said:

claiming to be MPs !!!!!!!!!!!!!!

I was quoted 21 weeks for an appointment to see a Gastro consultant. My doctor got it brought
forward by 5 weeks. I complained to another doctor in the practise that it was still too long to
wait. He suggested using patient power and to angrily phone the consultants secretary. I had an
appoinment two days later. Derek.

"Derek F" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Quoted message said:

I was quoted 21 weeks for an appointment to see a Gastro consultant. My

doctor got it brought forward by 5 weeks. I complained to another doctor in the practise that it
was still too long to wait. He suggested using patient power and to angrily phone the consultants
secretary. I had an appoinment two days later. Derek.

I'm trying to get a sense of the difference between the US system (where I live) and the UK. In
the US wait times getting an appointment with a Dr. are not typically a major problem - at least
in my experience - unless you are targeting are really good one. Our problems seem to revolve more
around $s. There is sort of a hole where people earn to much to be covered by public assistance
and not enough to get insurance or pay for things on there own. Also, insurance costs are rapidly
rising causing people to cut back on their coverage. And drug costs in the US are probably double
those in the UK.

On the other hand, if you can afford it, the quality of care in the US is excellent and, as you can
sense from this board 🙂, Drs. have a great deal of freedom.

Thoughts?

Bill

"]news:[email hidden]...

Quoted message said:

"Derek F" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Quoted message said:

I was quoted 21 weeks for an appointment to see a Gastro consultant. My

doctor got it brought forward by 5 weeks. I complained to another doctor

in

Quoted message said:

Quoted message said:

the practise that it was still too long to wait. He suggested using

patient

Quoted message said:

Quoted message said:

power and to angrily phone the consultants secretary. I had an

appoinment

Quoted message said:

Quoted message said:

two days later. Derek.

I'm trying to get a sense of the difference between the US system (where I live) and the UK. In
the US wait times getting an appointment with a Dr.

are

Quoted message said:

not typically a major problem - at least in my experience - unless you are targeting are really
good one. Our problems seem to revolve more around

$s.

Quoted message said:

There is sort of a hole where people earn to much to be covered by public assistance and not
enough to get insurance or pay for things on there own. Also, insurance costs are rapidly rising
causing people to cut back on

their

Quoted message said:

coverage. And drug costs in the US are probably double those in the UK.

On the other hand, if you can afford it, the quality of care in the US is excellent and, as you
can sense from this board 🙂, Drs. have a great deal

of

Quoted message said:

freedom.

Thoughts?

Bill

Yes your correct .......the USA does afford freedom of choice in medical

care providing you are either entitled or can afford it Pretty much the same in the UK only
difference being those who are entitled are rationed by long waiting lists whereas the very rich can
afford to pay privately Those in the middle either have extra private medical insurance .....BUT
unlike in USA ....it only covers immediate diagnosis and treatment .....if you have certain
conditions or a chronic disease then it will not continue to pay

Since salaries in the USA are much higher than the UK and USA housing costs are much much lower and
USA taxation does not bite until you earn about 3 or 4 times UK level .............the general
standards of living in the USA even accounting for your health care costs are way better than the UK

Dictator Blair and his cronies have hit us so hard with one tax after another that many people are
now in very difficult straits

We have many wonderful USA friends who when we sit and truly compare whats going on on both sides of
the atlantic they are totally appalled at what we are going through