"Well man" clinics

Psamathe
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Re: "Well man" clinics

Postby Psamathe » 7 Dec 2017, 3:37pm

Si wrote:.....
Recently I had a blood test for something else. Next day I got a call from receptionist: "please come into the surgery right away as your blood is borderline!!!". "borderline what?" I asked, slightly alarmed. "I don't know" she said, "it's just borderline so you'd better come in ASAP". So I turned up the next day, nurse (who knows I ride a bike a lot) looked at my file and said it was a waste of tie me coming in.....it was just that my cholesterol was borderline....if I had happened to be an overweight coach potato...the fact that I exercise everyday means that it is fine apparently. Yep, they are good at putting the wind up you!

I can see the challenge for the NHS on that. To get a sensible interpretation of test results would need a qualified person (GP) to check them (maybe cross-checking your file 'cos I'm sure they don't normally "know" their patients). But GPs don't have time to see all their patients, let alone scan all results.

So do you try and increase the GP workload even more and avoid a few people being called-in unnecessarily or do you set a "rule" allowing unqualified people to process the results and accept that some people will be called in unnecessarily?

I've no idea which is right but given the pressures Primary Healthcare is under I'd hope somebody has done some math to work out the most efficient methods.

But I agree about "putting the wind up you" - several years ago a routine ultrasound identified a "lump" I should not have had so referral for a CT scan. Around time results should have been in I called the surgery and, "yes results were in and no they could not tell me the outcome and I'd have to see my GP". Given the 3 weeks wait I said can he call me and later in the day reception called back saying GP would need to see me face to face to discuss the results (in 3 weeks time). That was (unsurprisingly) a very very worrying 3 weeks.

Ian

Thornyone
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Re: "Well man" clinics

Postby Thornyone » 7 Dec 2017, 5:52pm

bigjim wrote:I attended one of these clinics about 12 years ago. I was then called in by my GP who told me I had failed my MOT because my PSA levels were 16 and it was almost certainly cancer. I then had to wait a month, over Xmas as well, worrying myself stupid, before I got to see a consultant. He examined me [finger test] then told me to go away, but have another blood test. Second reading was 0.75. Nothing wrong. I've just had an email this morning to ask me to attend another as I am subject to 20% CVT risk. Don't know where they get that from? Run, swim, ride up to 100miles in a day and lift weights 3 times a week.
By the way there is an alternative BMI test. Google it. Gives a more accurate result.

Your point about PSA is interesting, and may have relevance to cycling. If PSA is to be read a man should refrain from ejaculation and from cycling for several days before the test, but I wonder how routinely the point is made to chaps about cycling. By the way, when I attended a study day on prostate cancer some years ago the urologists there had mixed opinions about personally taking a routine PSA test, with lots of talk of “cans of worms”. I have had a PSA test a few years ago, when I complained about having to gallop to the loo at work. The PSA was fine, but the gloved finger found a bit of enlargement. My head is back in the sand at present!

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bigjim
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Re: "Well man" clinics

Postby bigjim » 7 Dec 2017, 6:03pm

If PSA is to be read a man should refrain from ejaculation and from cycling for several days before the test,

I did a lot of googling before my second PSA test. The advice was to refrain from cycling, sex, alcohol, tea and coffee for two weeks [may have been one] before the test. All these things evidently irritate the Prostate and result in false readings.
Nothing left to prove. http://adenough1.blogspot.co.uk/

softlips
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Re: "Well man" clinics

Postby softlips » 7 Dec 2017, 7:51pm

Thornyone wrote:
bigjim wrote:I attended one of these clinics about 12 years ago. I was then called in by my GP who told me I had failed my MOT because my PSA levels were 16 and it was almost certainly cancer. I then had to wait a month, over Xmas as well, worrying myself stupid, before I got to see a consultant. He examined me [finger test] then told me to go away, but have another blood test. Second reading was 0.75. Nothing wrong. I've just had an email this morning to ask me to attend another as I am subject to 20% CVT risk. Don't know where they get that from? Run, swim, ride up to 100miles in a day and lift weights 3 times a week.
By the way there is an alternative BMI test. Google it. Gives a more accurate result.

Your point about PSA is interesting, and may have relevance to cycling. If PSA is to be read a man should refrain from ejaculation and from cycling for several days before the test, but I wonder how routinely the point is made to chaps about cycling. By the way, when I attended a study day on prostate cancer some years ago the urologists there had mixed opinions about personally taking a routine PSA test, with lots of talk of “cans of worms”. I have had a PSA test a few years ago, when I complained about having to gallop to the loo at work. The PSA was fine, but the gloved finger found a bit of enlargement. My head is back in the sand at present!


Patients should be advised before a PSA test that a positive test doesn't diagnose anything. It just means more investigation is required.

John Anderson was a friend and colleague of mine, I started to get my PSA done after he was diagnosed and died from the disease.

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Psamathe
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Re: "Well man" clinics

Postby Psamathe » 7 Dec 2017, 8:03pm

bigjim wrote:
If PSA is to be read a man should refrain from ejaculation and from cycling for several days before the test,

I did a lot of googling before my second PSA test. The advice was to refrain from cycling, sex, alcohol, tea and coffee for two weeks [may have been one] before the test. All these things evidently irritate the Prostate and result in false readings.

Bit off-topic (apologies to OP) but earlier this year returning from a ride, went to the loo and was peeing blood, GPs treated it as a matter of urgency, used their index finger (fine) but wanted a PSA test to be double sure. I was told no cycling (sex, etc.) for 2 weeks before the test. Most of my Googling (incl on NHS sites) seems to say 48 hrs.

Ian

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NUKe
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Re: "Well man" clinics

Postby NUKe » 7 Dec 2017, 10:42pm

I find them useful, Nurse who did the last one, seemed knowledgeable, even people who do exercise can have CV problems, they are not extensive but they do allow them to pre screen . If they feel there is risk you will end up having further tests and discussions with your GP.
We can all kid ourselves that BMI, is no good, and super athletes can appear obese, but for most people outside the range and your carrying extra fat, I should know I've lied to myself most of my adult life. Yes its not too bad a little extra weight if you exercise, but most people would benefit from a bit less weight.
As for using a belt as a guide its just wrong men usually claim there belt size is their waist size. When quite often that another 4 to 6 inches as they measure their hips and ignore the lump hanging over the top.
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Vorpal
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Re: "Well man" clinics

Postby Vorpal » 8 Dec 2017, 6:41am

NUKe wrote: Yes its not too bad a little extra weight if you exercise, but most people would benefit from a bit less weight.

Maybe they would benefit, in terms of most people feel more comfortable, and find exercise easier if they are within a 'normal' range for BMI. But if there is no sginificant difference to health outcomes, and they are happy with themselves, why should other people tell them that they need to to lose weight? If they aren't happy with themselves, how much of that is external pressure?
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Tiberius
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Re: "Well man" clinics

Postby Tiberius » 8 Dec 2017, 7:43am

I have a WM check up every nine months....I'm only too happy to go.

My Dad had two strokes which eventually saw him off, and my Mother had a stroke which is seeing her end her days in a nursing home. As you can imagine, I am keen to avoid either scenario.

SO, I have the checks, I take the statins and I accept the advice of the nurses and Doctors. Is their advice correct for me ??...All that I know is that I feel as fit as a fiddle, I have no side effects from the statins and I haven't had a stroke.

That'll do for me.

Thornyone
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Re: "Well man" clinics

Postby Thornyone » 8 Dec 2017, 8:34am

My point about PSA was meant to draw attention to the fact that cycling could influence a reading, and when I was given a PSA check I was not warned to avoid cycling for a while beforehand. It is unlikely that the GP concerned cycled regularly so he probably didn’t even think about it. Incidentally, whilst PSA can be useful, it is possible to have prostate cancer and yet have a PSA reading in the normal range. On the other hand my father had a considerably elevated PSA and a somewhat suspicious-feeling prostate, but both needle and subsequent core biopsies proved negative, though he did have a grossly (benign) enlarged prostate.

Though I referred to “belt notches”, I probably use the side view in the mirror more often. I think most of us know really when we could benefit from shedding a bit of excess. I would never use a BMI measuring contraption as a guide, it isn’t necessary. It is also interesting that sumo wrestlers apparently tend to have a very high BMI but low levels of fat around their internal organs (and it is visceral fat which is of most concern in relation to cardiovascular health). What I find unacceptable in the way that BMI is used is that it is still, seemingly, used quite uncritically. It was implied to me that because increasing age is a risk factor, that alone might tip me into a higher risk category GIVEN MY BMI. So BMI is used as an unreliable (because inaccurate) factor.

As far as screening is concerned it clearly makes sense that an individual whose family history points to particular health risk factors, is monitored, whether the disease be cardiovascular or a genetically-associated cancer, but this is possibly an argument for more targeted family-history based screening.

Tizme
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Re: "Well man" clinics

Postby Tizme » 8 Dec 2017, 2:40pm

I have had one invite to date, which I attended. During the check I was subjected to a fair bit of tutting as I had smoked during my youth, so around 40 years since I last had a cigarette. The fact that since quitting I have always maintained a high level of fitness and managed to run 13 marathons (all under 3rhs 30minutes) and completed 8 Ironman triathlons (2 at the Hawaii World Championships) since turning 45, was "irrelevant", or so it seemed. Heart, BP and cholesterol levels all fine, but the clearly overweight, unfit nurse continued to stress how I had ruined my health and I "could never get it back" and she would have to "mark me down." :shock:

As an aside, a few weeks after completing the All Arms Command Course (green beret course for non-marines), I was informed during a medical that I had a heart murmur and should "take it easy" :roll:
28 years after my qualifying jump to gain military parachutists wings an x-ray showed up a compression fracture of T4/T5 in my spine (it was a really bad landing), I did another 91 jumps, good job I didn't know any better. :D

Psamathe
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Re: "Well man" clinics

Postby Psamathe » 8 Dec 2017, 2:53pm

Tizme wrote:I have had one invite to date, which I attended. During the check I was subjected to a fair bit of tutting as I had smoked during my youth, so around 40 years since I last had a cigarette......

I gave up 16+ years ago and on one occasion visiting GP for a lump in my neck he thought "nothing to worry about" and then asked about smoking and on the then "gave up 13+ years ago" he decided to refer me to a consultant just in case. NHS do seem to take any history of smoking as significant. Consultant got it ultra sounded and was going to take a biopsy but ultra-sound was ok so he gave me the all-clear. And I felt guilty wasting NHS resources but also relieved they had checked it out thoroughly.

Ian

brynpoeth
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Re: "Well man" clinics

Postby brynpoeth » 8 Dec 2017, 3:04pm

I gave up smoking 43 years ago and drinking 27 years ago, maybe I should lie to avoid being criticised :wink:

Passive smoking was a big problem until quite recently

I understand most males over 40 have an enlarged prostrate but it develops very slowly. Probably most of us have worn joints etc etc without symptoms
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Psamathe
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Re: "Well man" clinics

Postby Psamathe » 8 Dec 2017, 3:12pm

brynpoeth wrote:.....
Passive smoking was a big problem until quite recently....

<offtopic>People always said ex-smokers were the worst at tolerating the cigarette smoke from smokers but it never bothered/bothers me. I don't dislike it and I don't get enough for it to be a health impact. But then when I gave up I was lucky in that it was easy - I stopped and that was the end of it (no patches, no special sweets, no vaping). These days there are other forms of air pollution that are far more dangerous and far more widespread and have been discussed at length recently on other threads - so I only mention it in the context of cigarette smoke and wont divert the thread off in "that" direction.</offtopic>

Ian

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Re: "Well man" clinics

Postby Bonefishblues » 8 Dec 2017, 3:45pm

Nurse seemed embarrassed at mine, saying it was of little use to someone like me* - and the people who really needed it didn't go along to them. I expect someone's producing stats from them to show their impact on public health :wink:

*who is dull and paranoid in equal measure, and who knows most of his body's relevant stats :?

flat tyre
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Re: "Well man" clinics

Postby flat tyre » 9 Dec 2017, 12:41pm

I was first asked to attend a clinic 5 years ago as they said my BP and Cholesterol levels were high. After weighing me they said I was "borderline diabetic" (whatever that means). A that time I was in my late 50s and hadn't considered myself to be overweight. Since then I eat slightly less and cycle a lot more and have lost about 1.5 stone. Now in my mid 60s I think I'm a lot fitter than I was 10 years ago and I can go up hills a lot faster! So, I suppose in my case there was some benefit in going along to the clinic.