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Author: ipes2

GRAVE'S DISEASE (penyebab hyperthyroidism)

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 Author| Post time 20-8-2022 11:56 PM | Show all posts
sue_0684 replied at 20-8-2022 11:46 PM
BP meds telmisartan 80 mg ,once daily.

oh 1 agent je
ok je lah jika telmi je (ini class ARB)
byk lagi benda boleh add eg amlodipine (ini class CCB), doxazosin (in alpha-Blocker), bisoprolol (ini beta-Blocker)
jika diperlukan, tambah lah amlodipine (does telmisartan tu dah max dah tu)
u will be fine lah
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Post time 21-8-2022 12:10 AM From the mobile phone | Show all posts
ipes2 replied at 20-8-2022 11:56 PM
oh 1 agent je
ok je lah jika telmi je (ini class ARB)
byk lagi benda boleh add eg amlodipine (ini  ...

bisoprolol sama group dgn propranolol kan doc?mmg amik propranolol before.lepas resting pulse sy back to normal , doctor bgtau dah boleh stopped.so sekarang amik carbimazole dgn telmi je..
inshaallah.harap2 ok lah bp lepas ni..
sekarang ni lepas doctor naikkan dose telmi,  bp sy dah dapat range 115 -130++ .. sebelum ni selalu 130++  - 150..
tp diastolic kadang naik 90 -93 ..kdg dpt 84-89..
masa kena covid diastolic mmg 90++ semasa kuarantin seminggu tu.
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 Author| Post time 21-8-2022 12:17 AM | Show all posts
sue_0684 replied at 21-8-2022 12:10 AM
bisoprolol sama group dgn propranolol kan doc?mmg amik propranolol before.lepas resting pulse sy b ...

ye, bisoprolol adalah cousin kepada bisoprolol tetapi kita guna propanolol untuk kurangkan beta-1 dan beta-2 adrenergic symptoms.. jadi kita guna propanolol dalam thyrotoxicosis, dalam migraine dna beberapa specialized situations eg portal hypertension (org yg lievr disease nye sudah teruk), kdg2 utk BP, kdg utk irregular heart rhythms, dan diguna secara haram dalam snooker kerana ia akan cool kan org itu dan game nya akan improve, dalam people going for exams, job interveiews etc

bisoprolol adalah beta-1 adrenergic blocker.. ia khusus utk BP, heart rhythm probs eg AFib, org yg baru lepas heart attack, org yg ada onh=going coronary disease

bila thyroid dah elok, kita stop guna propanolol
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 Author| Post time 21-8-2022 12:18 AM | Show all posts
sue_0684 replied at 21-8-2022 12:10 AM
bisoprolol sama group dgn propranolol kan doc?mmg amik propranolol before.lepas resting pulse sy b ...

BP ini sudah OK dah ni
do the diary like i suggested than you will know your BP behaviour
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Post time 21-8-2022 12:29 AM From the mobile phone | Show all posts
ipes2 replied at 21-8-2022 12:17 AM
ye, bisoprolol adalah cousin kepada bisoprolol tetapi kita guna propanolol untuk kurangkan beta-1  ...

owh.noted doc ..
patut sy dpt propranolol masa awal2 detected hyperthyroidism sbb nye sy cpt nervous,mcm ada mild anxiety.teruk btol.nk driving pun takut mcm2 pikir sampai kan kalau tgok kete depan yg hampir nk langgar kete lain,sy yg tukang tgok ni jadi nervous.berpeluh2.
lagi simptom,jadi kurang fokus ,mudah lupa..tp yg obviousnya, insomnia yg teruk la doc dgn cpt nervous..
seksa btol kena hyperthyroid ni.
dlm adik bradik,sy yg 1st experience penyakit ni , jadi susah org nk faham.
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 Author| Post time 21-8-2022 12:34 AM | Show all posts
sue_0684 replied at 21-8-2022 12:29 AM
owh.noted doc ..
patut sy dpt propranolol masa awal2 detected hyperthyroidism sbb nye sy cpt nervo ...

beres.. rasanya all points are slowly becoming under control, so will be ok overall soon.
ye jika ada hyperthyroid, gitu lah, nervous dan panic tak tentu pasal, dalam bilik sy pon pesakit2 ni pacing around suruh duduk tak mau
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Post time 28-8-2022 11:36 AM From the mobile phone | Show all posts
salam doc..  @ipes2 , nk tnya untuk grave's Disease ni mmg akan effect menstrual cycle bg ppn kan.so biasanya tempoh period tu akan panjang ke pendek?ada possiblity akan stop a few months ke?.kalau menses stop mcm mana doc?..
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 Author| Post time 29-8-2022 09:26 PM | Show all posts
sue_0684 replied at 28-8-2022 11:36 AM
salam doc..  @ipes2 , nk tnya untuk grave's Disease ni mmg akan effect menstrual cycle bg ppn kan.so ...

waalaikumussalam..
thank you for tagging me

jawapan utk soklan awak, tgk Clotting System tu (mechanism yg sy explain tu taklah setepat itu, dan ia byk kaitan dgn sex hormones etc)

Ya, Grave's ada effects pada menses.
Graves = hyperthyroid effects.
Jadi, semua benda hyper.
Jadi, semua benda cepat.
Perangai = hyper /panic2 /anxious
Pergerakan = cepat.
Reflex = hyperreflexia.
Jantung = cepat.
Fikiran = cepat (celaru, takleh tido, berpusing2 je atas katil)
Percakapan = laju, pressured speech.. dok berckp je, jika nak interject pon susah
Metabolism = laju: habis calories dibakar dgn cepat, lalu jadi kurus dan cepat lapar.. makan banyak tapi terus dibakar calories nya; maka banyak lah haba terbentuk maka boleh pakai T-Shirt je dtg clinic Thyroid padahal tgh snow kat luar
Bowels = laju tarnsitnya.. makan jap je dah nak poo; malah, tak sempt pon colon nak serap apa2, maka diarrahoea dan kerap ke toilet
Clotting system = cepat; berdarah dari menses pon jap je sebab dah clot dah pendarahan tadi; so, menses nyer jarang dan jika berdarah pon, sikit je
Menses = cepat terhenti dan cycle pon laju je; berdarah pun sikit atau stop terus
Fertility = rendah atau langsung tak fertile sebab mense cylce tak ada pon
Energy = cepat sgt dibakar sampaikan sentiasa keletihan





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Post time 29-8-2022 10:31 PM From the mobile phone | Show all posts
ipes2 replied at 29-8-2022 09:26 PM
waalaikumussalam..
thank you for tagging me


haha . hampir semua yg doc list out tu sy dah experienced..:
masa jadi tu sy pun pelik apa kena dgn aku ni.   ,ni sblm diagnosed the grave s disease.
thanks doc for the answer.
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Post time 21-12-2022 07:21 PM From the mobile phone | Show all posts
Edited by sue_0684 at 21-12-2022 07:29 PM

salam doc @ipes2 , lama tak update sini.
19/12/22 sy dah amik RAI (15mCi).doctor decide buat awal sebab last Nov tu blood test results: tsh still low 0.03, t4 :13.7,and tsi :9.30.. oktober to nov consumed carbimazole 20mg daily.

Dari july lagi doctor observed. Starting July to October tu consumed carbimazole 10 mg
daily,reduced dari 30mg to 10mg(July:tsh:0.26,t4:18.0++,tsi:9.16).            then october relapsed :tsh :<0.01,t4:17.3,tsi: almost 9.4 ).

Doctor planning next year bln 5,tp awal2 lagi dah relapsed.3 bln reduced carbimazole,dtg balik simptom hyperthyroid.dgn menses cycle jadi kacau kejap, Sept -October tu jadi susah sikit nak tido.
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 Author| Post time 24-12-2022 12:29 AM | Show all posts
sue_0684 replied at 21-12-2022 07:21 PM
salam doc @ipes2 , lama tak update sini.
19/12/22 sy dah amik RAI (15mCi).doctor decide buat awal se ...

ok alhamdulillah sebab dah decide for RAI
di USA, kene je Graves' for the first time pon endocrinologist depa akan advise for RAI
sini pon kita agak quick utk kata begitu

(rasanya awak ni diturunkan carbimazole terlalu cepat ke? jika Graves', kami pun on carbimazole for 18 months, sebelum kita beri drug holidays).

how is it going with the RAI at the mo?
all ok?
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Post time 24-12-2022 08:32 AM From the mobile phone | Show all posts
ipes2 replied at 24-12-2022 12:29 AM
ok alhamdulillah sebab dah decide for RAI
di USA, kene je Graves' for the first time pon endocrino ...

maybe jgk doc,turunkan dos dgn cepat.
lepas 6 jam RAI,leher bengkak dgn sakit .nk minum air pun sakit,mkn roti je hari tu dah la lapar lepas balik rumah tu.
tp sakit dah hilang pagi esok nya.jadi suara ella plak dlm 2 hari.
tp dah ok sekarang cuma leher bengkak lagi sikit.doctor on carbimazole 10mg daily after RAI.
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Post time 24-12-2022 08:33 AM From the mobile phone | Show all posts
sue_0684 replied at 24-12-2022 08:32 AM
maybe jgk doc,turunkan dos dgn cepat.
lepas 6 jam RAI,leher bengkak dgn sakit .nk minum air pun sa ...

so 4 weeks after RAI ada follow up appointment dgn doctor.-14/1.
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 Author| Post time 28-12-2022 06:05 AM | Show all posts
sue_0684 replied at 24-12-2022 08:32 AM
maybe jgk doc,turunkan dos dgn cepat.
lepas 6 jam RAI,leher bengkak dgn sakit .nk minum air pun sa ...

beres. make sure jgn naik bus / taxi or be in enclosed spaces dgn org awam eg dalam lift ke tec
dok je dalam bilik dan pasti kan org beri u food kat pintu bilik dan u amik bila org tu dah belah.
flush toilets 2 kali dan basuh cutleries elok2. jauhkan diri dari kids dan especially pregnant women.
jgn bagi pets dtg dekat2. jgn riba cats or kids.. radioactive iodine tadi akan di buang oleh body melalui kidneys ie into urine so dalam bladder u tu ada traces of radiating iodine ions. after few days, boleh la break this confinement.
di uk and ireland, kita letak dalam bilik khas sehari dan esok kelik rumah asingkan diri sehari dua.

biasanya, kami start balik CBMZ 7 days after RAI sebab if start awal, failure rates of the RAI is higher

good luck

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 Author| Post time 28-12-2022 06:05 AM | Show all posts
sue_0684 replied at 24-12-2022 08:33 AM
so 4 weeks after RAI ada follow up appointment dgn doctor.-14/1.

beres
ok je nanti insyaAllah
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Post time 28-12-2022 08:34 AM From the mobile phone | Show all posts
ipes2 replied at 28-12-2022 06:05 AM
beres. make sure jgn naik bus / taxi or be in enclosed spaces dgn org awam eg dalam lift ke tec
do ...

Alhamdulillah,
dah habis kuarantin 7 hari isnin lepas.sy dah mula masuk office smlm.masa 1st 3 days tu mmg sy x keluar ke mana2 doc.mknn pun order grab.lepas 3 hari tu pun duk jauh2 je dgn house mate.
getting better 2nd week ni.leher pun tak ada sakit apa dah.tidur pun ok.cuma since  last week after RAI mudah mengah sikit tp tak ada lah teruk sgt.
Bila berjalan cpt2 tu mengah sikit.tp kalau relax lepas tu ok dah.cuma minggu ni getting better tak ada lah mudah mengah sgt.

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 Author| Post time 2-1-2023 01:29 AM | Show all posts
sue_0684 replied at 28-12-2022 08:34 AM
Alhamdulillah,
dah habis kuarantin 7 hari isnin lepas.sy dah mula masuk office smlm.masa 1st 3 day ...

beres
sebaik sahaja buat RAI, memang akan ada sedikit leak of thyrid hormones dan many ppl dapat acute exacerbation of hyperthyroid mereka.. jap je, few days
pastu settle balik
itulah tu yg awak lalui jap tu
nanti slow ly awak akan jadi hypothyroid maybe over 1 2 3 years dan ambil sahaja lah thyroxine tablet harian
ini jauh lebih mudah dari graves disease

make sure ambil thyroxine tabs awal2 pagi 30mins sblm breakfast etc

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Post time 2-1-2023 09:06 AM From the mobile phone | Show all posts
ipes2 replied at 2-1-2023 01:29 AM
beres
sebaik sahaja buat RAI, memang akan ada sedikit leak of thyrid hormones dan many ppl dapat a ...

ok .doc.tq for the info.
anything i will update here.
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Post time 3-1-2023 12:12 AM From the mobile phone | Show all posts
Edited by sue_0684 at 3-1-2023 12:14 AM
ipes2 replied at 2-1-2023 01:29 AM
beres
sebaik sahaja buat RAI, memang akan ada sedikit leak of thyrid hormones dan many ppl dapat a ...


salam doc @ipes2, nk tanya lagi..  . kalau hypothyroid susah ke nk maintain berat badan? mudah weight gain ye?
Currently ni pun berat sy naik lagi ,58 kg padahal dah btol2 control portion mknn,oily food pun reduced, briskwalk. I read somewhere,easy gaining weight after RAI . btol ke?
penat betul gini bila ada thyroid problem ni..dlm 1st week RAI tu pun mcm mood swing je,nasib baik MC .Luckily i have good friends to talk with .
Tak semua org phm pasal hypo/hyperthyroid.
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 Author| Post time 9-1-2023 02:15 AM | Show all posts
sue_0684 replied at 3-1-2023 12:12 AM
salam doc @ipes2, nk tanya lagi..  . kalau hypothyroid susah ke nk maintain berat badan? mudah w ...

waalaikumussalam

bila kita ada overactive thyroid, kita akan lose weight (tengok Kuiz Q288 tuh, dan explanantionnya pada Answer To Q288). Jadi, kita akan jadi slim. Tetapi, kurus ini bukanlah kurus yang sehat, dan bukanlah yg natural untuk badan pesakit tadi.

Bila dia sudah ditreat, dan mula ambil thyroid tablets, maka tengoklah pada berat badannya semasa TFT nya normal. BMI pada ketika TFTnya normal adalah BMI dia yang sebenarnya; jika sedikit lebih dari yang pesakit itu suka, maka bolehlah dia buat urusan2 untuk turunkan BMI itu sikit. Cari yang elok ialah kurangkan calories dan carb dan fat / oily food kerana ini sangat pasti menaikkan berat badan. Seeloknya, kurangkan calories (boleh calculate dgn buku2 online) dan banyakkan minum air selepas makan dan buah2. Ini memenuhkan perut, kurangkan rasa lapar. Makan ontime dan jgn miss apa2 meals; jika nak miss, bolehlah miss lunch.

Sekejapnya mood  changes tu. Yg penting, awak perlu berada pada TFT yang normal. Ini penting untuk kesihatan mental dan physical, cardiovascular, cholesterol metabolism dan bone juga musculoskeletal.

nanti akan OK je insyaAllah. Dan ingat, jika rasa penat ke, amals ke etc, bukan semuanya kerana thyroid tau.

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