General Medical issues thread

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Pushka

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Rheumatologist appointment today. Ended up being a long one. I’d had a negative Covid test done yesterday because once again I had a throat like I was trying to swallow marbles. Fourth time in about 5 months. I’d not had a GP visit about it because well, I’d put it off in a Covid world. Hmmm. She was happy to check my throat and feel for lymph glands. I can never feel these except when swallowing but she could feel several swollen ones. She said I need to see an ENT as soon as I could via GP.

Can’t see GP until 27th and i didn’t dare ask why it was happening. Thoughts?

She has just three patients with APS (it’s a little rare) who are supposed to have had Pfizer. All of us had AZ.
 

drron

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@Pushka had you told her about how you got your second AZ.My contact I talked to on Tuesday and she was saying she has had 3 patients with APS from South Australia having 2 doses of AZ.Plus a few more from other states.
 

Pushka

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@Pushka had you told her about how you got your second AZ.My contact I talked to on Tuesday and she was saying she has had 3 patients with APS from South Australia having 2 doses of AZ.Plus a few more from other states.
Yep. I was one and niece the other plus an unknown. I know she is close to SA CHO. Niece told her we’d both had it a few weeks ago.

The neighbour also with APS had Pfizer last week. His wife is hanging out in vain for Pfizer too. He knows I get frustrated with her.
 
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Quickstatus

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3 patients with APS from South Australia having 2 doses of AZ
Translation: people with an autoimmune disorder called anti phospholipid syndrome (APS) with history of thrombosis (blood clots - especially venous blood clots) should be offered PZ instead of AZ.

Some APS don’t manifest thrombosis but in other ways such as second trimester miscarriages, high number of first trimester miscarriages or premature births. Also preeclampsia. However, even those without history of thrombosis are generally thought to be at significantly higher risk of it.

APS is likely under diagnosed and I wonder of any of the known AZ related TTS cases also have some undiagnosed autoimmune tendencies. We know there is a female preponderance with APS and other autoimmune diseases. Slightly less with Covid/AZ related TTS

The AZ exclusion refers to APS with thrombosis but should really be any APS

I always recommend any women with the above pregnancy difficulties should have autoimmune tests and depending on results see a haematologist.
 
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Pushka

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Translation: people with an autoimmune disorder called anti phospholipid syndrome (APS) with history of thrombosis (blood clots - especially venous blood clots) should be offered PZ instead of AZ.

Some APS don’t manifest thrombosis but in other ways such as second trimester miscarriages, high number of first trimester miscarriages or premature births. Also preeclampsia. However, even those without history of thrombosis are generally thought to be at significantly higher risk of it.

APS is likely under diagnosed and I wonder of any of the known AZ related TTS cases also have some undiagnosed autoimmune tendencies. We know there is a female preponderance with APS and other autoimmune diseases. Slightly less with Covid/AZ related TTS

The AZ exclusion refers to APS with thrombosis but should really be any APS

I always recommend any women with the above pregnancy difficulties should have autoimmune tests and depending on results see a haematologist.

I don't know about the other man but I had a DVT in the jugular vein and Niece in her pelvis. She was expecting almost every day to get a DVT somewhere as her markers were very high but that doesn't always mean a clot will follow. We don't do the normal calf/PE thing. Mum also had autoimmune issues, (that's our inheritance line) but was never assessed other than for thyroid, and she had a stroke. I Also had pregnancy issues but APS wasnt even clinically discovered until the mid '80's so too late for me. My niece and I have parallel medical histories, even had the same laminectomy in our thirties. I do know the three of us are all on anticoagulants, Im on Xaretlo and niece and the other guy on warfarin.

The three of us, being in 1b were early to receive the vaccination and before ATAGI updated their advice re APS. Thanks to drron we got it sorted.
 
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Quickstatus

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tricky issue with lots of ethical dilemmas
(Re availability of Medicare to people who don’t follow health recommendations)
Apologies I’ve moved it here to get out of the covid rhetoric.

Should there be an ethical dilemma?. It’s a dilemma if a line is drawn in the sand.

If someone crashed their car while speeding should they be Medicare eligible?
What about someone who treats their condition say cancer with natural remedies then gets worse?
A homeless alcoholic who keeps drinking and then gets brain damage?
A woman who decides against medical advice and has a home birth, and then gets torrential bleeding?
Here is a new one which still hypothetical : what about the elderly who does not want euthanasia and prefers to keep medical intervention going?

If we are going to have a safety net, I think it’s best to have one without holes???
There is already rationing of health care but it tends to be centred upon futility /efficacy of care of treatment rather than centred upon personal decisions
 
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