[agambhandari]

Originally Posted by gkveda

He suggested Vitamin D 1000 mg (D Rise 1000) per day and for 4 weeks. Also, he suggested zinc + Selenium (Zincovit) which are good for muscles.

Have been taking this since last 2 weeks and hoping to see some improvement in coming 4-5 weeks

Also, Request doctors here to suggest If I am going in right direction? If not, please suggest right steps.

Your aggressive dieting could lead to few micronutrient deficiencies indeed.
Infact Vit D deficiency is much more common than most of us think, so taking the supplement for that is not a bad idea. I'm not sure about zinc and selnium, but they would not harm if you only take them in moderation and only a few weeks. Usually only 4-6weeks.

If you can afford it easily, you can get your Vit D levels checked so that there would be an evidence of any deficiency. and If there indeed is a deficiency would suggest you to add sachets of Vit D to a glass of milk once a week.

[Eddy]

I don't know of anyone in my circle who was not found deficient in Vitamin D unless he/she was taking supplements before the test.

It has become a lifestyle disease, especially in urban areas.

[luvDriving]

This post may not belong here. If so, please feel free to move it elsewhere.

This is one observation since the past few years. Whenever I have had the occasion to visit a doctor (either for myself or anyone else), the concerned doctor hears the symptoms, makes a cursory examination (if at all) and doles out a prescription.

I haven't had an occasion wherein the doctor has attempted to take a case history or put forward probing questions. Only on one occasion when we had visited a famous homeopathy specialist for my mother, the doctor spent an hour taking case history and asking various questions. For others, if we visit a second time, the doctor will just change the medicine or change the dosage.

My questions are -

1. Is this experience universal now ? Or am I just visiting the wrong people ?
2. Why not spend some time on diagnosis ?
3. Does doling out routine prescriptions mean income from either medicine manufacturers or medical shops ?
4. Is this due to lack of care towards patients or lack of time or some other factors ?

This is not to say that I lack any respect for either the profession or the doctors themselves. I am trying to understand the situation.

[civic-sense]

Originally Posted by luvDriving

1. Is this experience universal now ? Or am I just visiting the wrong people ?

It is high time we had the concept of a PCP (primary care physician) here. In the US, you always first visit your PCP and never a specialist. The PCP is always current regarding your medical history. Only when you need to visit a specialist, he refers you to one.

You can find a local physician and make him/her your PCP. It is a slow process but will eventually benefit you.

[rdst_1]

Originally Posted by civic-sense

It is high time we had the concept of a PCP (primary care physician) here. In the US, you always first visit your PCP and never a specialist. The PCP is always current regarding your medical history. Only when you need to visit a specialist, he refers you to one.

You can find a local physician and make him/her your PCP. It is a slow process but will eventually benefit you.

I would have guessed others had one, considering we have had a PCP ever since we were born. It was a paediatrician when we were young and then a friend of my father's who our whole family goes to when we entered out teens.
I guess I was lucky since we never moved around like some families have to. Just 2 years back we shifted base to our village and even now we get our regular checkups with our family doctor even though he is 300kms away. Will have to try and find someone local as well for the future but it seems difficult to build the same rapport and trust that quickly. Recently we had tried to do so with a renowned local doctor but he failed to administer proper medicine or dosage because of not knowing my father's history. This led to escalation of the disease and by the time we got to our regular doctor, the insignificant cough and breathlessness had turned into Septicemia, which eventually led to my father passing away in a short span of 20 days.
Since then it has been even more difficult to imagine going to someone else. We prefer to travel the 300kms, although we haven't faced any major illnesses since then. So who knows how we would tackle any issues in the future, but having a trusted PCP is definitely very important.

[aadya]

Originally Posted by luvDriving

This post may not belong here. If so, please feel free to move it elsewhere.

This is one observation since the past few years. Whenever I have had the occasion to visit a doctor (either for myself or anyone else), the concerned doctor hears the symptoms, makes a cursory examination (if at all) and doles out a prescription.

I haven't had an occasion wherein the doctor has attempted to take a case history or put forward probing questions. Only on one occasion when we had visited a famous homeopathy specialist for my mother, the doctor spent an hour taking case history and asking various questions. For others, if we visit a second time, the doctor will just change the medicine or change the dosage.

My questions are -

1. Is this experience universal now ? Or am I just visiting the wrong people ?
2. Why not spend some time on diagnosis ?
3. Does doling out routine prescriptions mean income from either medicine manufacturers or medical shops ?
4. Is this due to lack of care towards patients or lack of time or some other factors ?

This is not to say that I lack any respect for either the profession or the doctors themselves. I am trying to understand the situation.

I cant answer for the entire community - both patients and doctors, but for me. I am a General Physician and I avoided specialisation due to the fact that it makes life monotonous.

My consultation time varies with the problem facing me. It is usually 8-10 minutes for common illnesses like Fevers etc., For diabetes and other chronic diseases it is anywhere between 15minutes to 40minutes, including the counselling. Usually 8 minutes is the time required to diagnose the most common medical problems in the OPD and emergency(Thats the time given for the short medical case in Royal College of Physicians UK exams- for brief history, physical examination and counselling the patients).

Another angle is the fee paid to the doctors in our country is very less. Consider a doctor living in a metro spends 30 minutes per patient and charge 300 Rupees(most of the single doctor clinics charge this) and most times this fee includes a revisit. Its not even possible to earn a six digit amount if you consider the expense. I am just talking of ideal situation only.

IMHO :Ideally a consult lasting 10minutes would be productive in most cases.

[akshaymahajan]

Originally Posted by aadya

I cant answer for the entire community - both patients and doctors, but for me. I am a General Physician and I avoided specialisation due to the fact that it makes life monotonous.

IMHO :Ideally a consult lasting 10minutes would be productive in most cases.

Sorry for going a little OT here (Brand new to BLR and coming from a family of doctors, have never had to look for doctor recommendations earlier)

Since you are in BLR, can you recommend any Dermatologist preferably around the Ingdranagar area. All I need is to get a few Tricort shots around my jawline (ongoing treatment).

Appreciate it

[luvDriving]

Firstly, thanks for your responses.

Originally Posted by civic-sense

It is high time we had the concept of a PCP (primary care physician) here. You can find a local physician and make him/her your PCP. It is a slow process but will eventually benefit you.

We are trying to find a local physician as a PCP but we have had no luck so far. We have found a good pediatrician for our daughter (5YO) whom we trust.

Originally Posted by rdst_1

I would have guessed others had one, considering we have had a PCP ever since we were born.
This led to escalation of the disease and by the time we got to our regular doctor, the insignificant cough and breathlessness had turned into Septicemia, which eventually led to my father passing away in a short span of 20 days.

Very sorry for your loss and I can empathize because we lost my father in a similar fashion. He complained of acute stomach pain so we rushed to our PCP (this is 20 years ago) who got him admitted in a local hospital. One day later the local hospital asked us to move him to KEM as it was out of their hands. My father passed away a week later in KEM of acute septicemia.

Originally Posted by aadya

It is usually 8-10 minutes for common illnesses like Fevers etc., For diabetes and other chronic diseases it is anywhere between 15minutes to 40minutes, including the counselling. Usually 8 minutes is the time required to diagnose the most common medical problems in the OPD and emergency(Thats the time given for the short medical case in Royal College of Physicians UK exams- for brief history, physical examination and counselling the patients).

IMHO :Ideally a consult lasting 10minutes would be productive in most cases.

It is not about the time factor really (as your last comment clarifies). Accurately (or even trying to) diagnose the ailment is what I see lacking. This is purely while visiting a physician's clinic and not at any hospital.

[aadya]

Originally Posted by luvDriving

It is not about the time factor really (as your last comment clarifies). Accurately (or even trying to) diagnose the ailment is what I see lacking. This is purely while visiting a physician's clinic and not at any hospital.

Most of us usually have a differential diagnosis at the time of history taking itself. Usually in bigger hospitals, medical colleges and senior/expensive consultants(who has little more time to spend) we mention it on the prescription and give a brief update to the patient. General practitioners may not have sufficient time or resource to confirm the diagnosis. You can put a question like "Doctor, what do you think is troubling me?" might bring out the differentials.

[DCEite]

Talking about Vitamin D, this is one topic related to sunlight that no Doctor has been able to answer clearly.

What time is the best to get the Vitamin D from Sunlight ? Some doctors suggest early morning 7 am to 9 pm as the best time to get Vit D.

Other doctors suggest Mid of day as the best time to get Vitamin D - when the angle of the sunlight is such that our shadow is much shorter than our height.

Some doctors on the other hand ask to avoid 11 am to 2 pm sun.

This is very confusing topic and i am not sure if there is any agreement within medical community.

[archat68]

Originally Posted by DCEite

What time is the best to get the Vitamin D from Sunlight ?

Other doctors suggest Mid of day as the best time to get Vitamin D - when the angle of the sunlight is such that our shadow is much shorter than our height.

Some doctors on the other hand ask to avoid 11 am to 2 pm sun.

Mid day when the sun is at full strength.

[Tejas@perioimpl]

I'm out atleast 10 days a month in the sun all day but still have Vitamin D deficiency. Probably due to the fact that the sunblock doesn't allow it to be synthesised.

[AltoLXI]

Adding to the confusion:

I was told by some doctors that Melanin actually inhibits absorption of Vitamin D. So people in tropics also need as much Vit D compared to those in temperate zone.

https://en.wikipedia.org/wiki/Melanin

With humans, exposure to sunlight stimulates the skin to produce vitamin D. Because high levels of cutaneous melanin act as a natural sun screen, dark skin can be a risk factor for vitamin D deficiency in regions of the Earth known as cool temperate zones, i.e., above 36 degrees latitude in the Northern hemisphere and below 36 degrees in the Southern hemisphere. As a result of this, health authorities in Canada and the USA have issued recommendations for people with darker complexions (including people of southern European descent) to consume between 1000–2000 IU (International Units) of vitamin D, daily, autumn through spring.[citation needed]

[DCEite]

Originally Posted by archat68

Mid day when the sun is at full strength.

I can show you reports where its mentioned early morning as the best time.

[archat68]

Originally Posted by DCEite

I can show you reports where its mentioned early morning as the best time.

There is a concern of sun exposure and skin cancer, especially in white people. Therefore sometimes the morning period is recommended.
For dark skinned Indian people, melanin impairs vit D production. Hence, stronger sunlight is recommended.