It used to be that we doctors and hospitals felt that our only responsibility was to treat the sick patients who walked through our doors. Nowadays, we feel that we also have a duty to try to prevent those illnesses from developing in the first place. This arises from the simple fact that treatment for disease is most effective before the symptoms arise, so catching a potential illness in the early stages is essential for good health.
Every hospital and clinic offers some form of screening examinations encouraging you to undergo physical examinations, blood and other testing. There are many different types of screening tests available, and as such it can be difficult for you to judge which tests should be performed and whether the benefits justify the expense. Let me tell you about the screening programs that are offered at Hua Hin’s newest hospital. The ideal medical screening tests are ones that can be done easily, with minimal risk, are reliable in detecting existing disease and can also detect the presence of conditions which may not be causing any problems at the present time.
A test is said to have a ‘predictive value’ if it can forecast the future by identifying situations which will lead, if untreated, to problems occurring in the future. The purpose of screening examinations is to detect ‘hidden’ problems and to treat them before they become life threatening. Diabetes is a good example. Nobody becomes diabetic overnight. Diabetes comes on slowly and there are no symptoms in the early stages. Recent studies in America have shown that onethird of all adults with diabetes don’t even know they have the condition. In Thailand that number increases to 50%.
Our testing can detect the change in the level of sugar in your blood before it becomes serious enough to cause damage to your body. We measure the Fasting Blood Sugar Level (FBS); this is the level of sugar in your blood when you have not eaten any food for several hours. Ideally it should be below 100 (5.5 on the International scale). If it is higher than this, up to about 110, we will advise you to be cautious in taking sugary foods and to try to loose some weight.
If it is higher than that we may suggest that you have a more extensive testing, a Glucose Tolerance test (GTT) and a Hemoglobin A1C test that will identify if you have diabetes. When diagnosed in its early stages, diabetes can often be treated with dietary changes, more exercise and oral medication. If left too long then daily insulin injections will be needed. On starting the program you will be seen by a doctor who will ask you about your health and previous illnesses.
If there are any diseases that occur in your family, and for which we are not testing, we will suggest that we add these to the program; sickle cell anemia or thalassemia would be examples of this. In this way the program is individualized to your health profile. The Doctor will then perform a routine physical examination. Various programs are available and these are targeted towards different age groups. There are some tests that are common to all of them.
We will test your blood for anemia and leukemia, for diabetes, for gout, and for liver, kidney and cholesterol problems. We will also test your urine for infection and for abnormal contents. You will have an X-Ray of your chest taken and an ultrasound of your abdomen to detect any problems or growths in your chest or abdomen. An electro-cardiogram (ECG) will be performed in order to study your heart and look for early suspicious changes. Some extra tests are included for female patients: a Pap test and mammogram in order to screen for female cancers. Some of the tests added in the more extensive programs recommended for patients over 45 include tests of the thyroid and markers for cancers, including a Prostate Specific Antigen (PSA) which can identify the presence of cancer of the prostate.
The exercise stress test is a very useful test and has good predictive value. An ECG of your heart is taken while you are at rest and gives a good assessment of the heart’s ability to perform in this situation. When you are more active, walking, climbing stairs or exercising, your heart will have extra demands placed on it and may not work as well. For this test, the ECG leads will be placed on your chest in the normal way and then you will walk briskly on a treadmill while the ECG is recorded and observed.
This will tell us how your heart performs when under stress and is useful in giving information that will assist us to suggest treatment to prevent a heart attack in the future. You should not have anything to eat or drink for at least eight hours before the testing, but a few sips of water are allowed. You should not have any alcoholic drinks for twenty-four hours before the testing, as it will alter some of the results. The results of the tests will be discussed with you and suggestions will be made about how any abnormal findings should be handled. Additional testing or follow up testing may be recommended as well as life-style changes.
You should keep these results, as it can be useful to compare the results from one year to another; we will, of course, keep a copy in your file at the hospital. Usually the whole of the checkup program will be completed in a few hours at one hospital visit. The costs of these check-up programs are very reasonable. During the Bangkok Hospital Hua Hin opening period, the Premium program, for instance, is priced at 6630 B (168Euros). Dr Michael Moreton is the International Medical Coordinator at Bangkok Hospital Hua Hin. He is happy to answer any of your health related questions.