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Re: Which Specialist to see?
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What you can do is ask your mother to see her GP and ask him/her to arrange for an urgent follow up to SHG to see a GI specialist there, thats how SGH specialists take in new appointments. Your GP may also know which private specialist to direct your mother to.
You can also try calling Normah hospital to see if you can make an appointment to see a general surgeon-Dr. Goh.
Or when your mother has another attack of pain and fainting, get a family memeber take her to an emergency department either in SGH or a private hospital immedeately and your mother should receive follow up care from there.
Sorry but I am not familiar with which specialists are around in Kuching.

And Jinpeng-don't just simply blare out medical jargon and differential diagnoses-it can mislead people and cause more distress and anxiety. Some of the information you have provided is also inaccurate.

Posted on: 2009/11/18 6:34
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Re: Which Specialist to see?
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Hey, how about you try another hospital beside kuching... If you want, I can arrange you transport..

Posted on: 2009/11/18 13:29
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Re: Which Specialist to see?
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Well first of all, I am sorry if I had cause any unnecessary panic attack or confusion. I was just telling out the differential diagnoses of abdominal pain for all to learn. For me, I don't think it is heart attack too (repeated heart attacks will be a Guinness Record) as 1/3 of them will expire at home, 1/3 in the hospital and the other 1/3 will escape. A tuberculosis is not panicking too as it is treatable. I didn't make any conclusion and was just trying to help, to save a life and sometimes one has to utter something which might raise an alarm but I think it is important to consider them and Stormpike, as an Engineer, I am sure will be able to handle the emotional equilibrium well. Furthermore, as an engineer, I am sure stormpike knows some medical jargons (it is good to learn too as we all are going to encounter some diseases some time in our lives) and I am not using them to the maximum at all and I tried to use layman's terms too.
Since they had done so many investigations, I am thinking of just 2 diseases ie 1: Irritable bowel syndrome and 2: abdominal migraine which are not fatal. My 2 pennies perhaps. I'm not thinking of cancer too as there re no loss of weight, no symptoms of low hemoglobin, no findings from scopes etc but do keep in mind. I am sure abdominal & pelvic ultrasound scans were done before to rule out stones (gall bladder & kidney). without urinary symptoms, it will unlikely.
And of course, one has to give due attention and prompt treatment. I am sure as a caring child, you will bring your beloved mum to the hospital as fast as you can and once in the hospital, keep on asking the doctors for advice (on her condition and the various specialists). Bring printouts of the diseases that you had researched too. I suggest you to bring her to see the doctor now even when she is not in pain and like what Socrates said, - keep on asking questions.

Good luck mate! =)












Posted on: 2009/11/18 17:48

Edited by jingpeng on 2009/11/18 18:11:50
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Re: Which Specialist to see?
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Well. Jingpeng. I would like to thank you for such an informative piece of advice. As you know, I am an engineer, some of these medical terms baffle me quite a bit. But I found them useful when at least I can check them on wikipedia. I cut and paste your response and attached as email to my mum. She seems to understand a lot better than I do.

I have just recently checked with my mum, she told me her stool is a bit of greenish and yellowish (not black) whenever she had such a bad tummy ache. Sometimes the green bits come out first, sometimes the yellow bits come out first. Cholestrol level is okay. Blood test is okay. Blood pressure was on the high side (but arguable cos when she test it at home, she is normally alright. 120/75 or there about). Blood sugar result is below 6.0. But she is taking her diabetes medication as instructed by her doctors. She hasn't lose any weight recently. She still has good appetite for food.

And she found she more often had such tummy ache whenever she had something more oily and spicy (fried kueh tiaw, etc).. But other time she had oily food and she haven't had that problem.

As I mentioned, she had a small gall stone, about the size of a green pea. Timberland Dr. Ting didn't think it was the cause. But I would also like to have your opinion.

She will be going back to Kuching next month and will probably arrange to go to Timberland again. I won't be coming, it is too far for me.

Posted on: 2009/11/18 23:47
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Re: Which Specialist to see?
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OMG stormpike can I advise you to seek for a full specialist review and not expect a professional opinion from this forum.

Let me point out that jingpeng's ideas which are IBD and abdominal migraine are not likely in your mother. Abdo migraine virtually only occurs in children and irritable bowel disease(IBD) does not lead to fainting.

There are a multitude of problems/conditions/diseases that may present with green/yellow stools, vomiting.
If you want something that may be more likely-it could be gallstones that impact and disimpact at the duct that drains into the small intestine-thats why she gets pain sometimes when she eats oily food. The green stools that your mother sees is usually caused by rapid movement of motion through the colon. True she may have an aspect of IBD causing her to pass green motion.
Some stones in the gall baldder or bile duct is difficult to visualize and to obtain a good view of the gall bladder CT scan can be used or during colonoscopy something called ERCP(edoscopic retrograde cholangiopancriaticography) is done to visualize the entire bile duct system.

I am not trying to insult jingpeng but I don't think he is a doctor, and if he is, then he isn't a very smart one.

Posted on: 2009/11/19 0:11
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Re: Which Specialist to see?
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Luminoth, I certainly did not expect to get a diagnosis over the Internet. It wasn't the purpose I came to the forum. I first came here to ask if anyone know any gastroenthologist in Kuching. I am not trying to doctor hopping around but I think it is fair that I should seek second opinion from another doctor.

The point is I was from Kuching but I am not based in Kuching at the moment. Neither is my mum. She will have to travel from Limbang and I have to travel from UK to Limbang and take her from Limbang to Kuching to see a doctor. I have been away from Kuching for more than 10 years and the doctors that I knew back then have probably retired. if only I knew which doctor to see, I probably won't have come to this forum. And I don't want to make an expensive trip back to Kuching not achieving anything.

You recommended me Dr Goh. I think that is Dr Helen Ngu's husband. Dr Helen's clinic is opposite Timberland. Isn't she a gynea specialist? I don't think Dr Goh is a gastroenthologist. If it was the female Dr Goh, it must be Goh Say Lak's daughter. She is also a gynea as far as I can remember. Unless she branched into other medical field then I am not sure.

I hope I am not asking too much from my fellow kuchinger friend. Really I want a name of a doctor specialised in digestive system and possibly his clinic or hospital he is based in. I am sorry if I have came to the wrong place

Posted on: 2009/11/19 1:33
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Re: Which Specialist to see?
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Dr./Mr. Goh at Normah is a general surgeon meaning he has expertise over the gastrointestinal system in a surgical point of view. I reccomended him as he would be able to provide an opinion on the cause of your mother's problems.

I also reccomended that you arrange for a specialist review in SGH through a GP which your mother will be able to do immedeately and she can expect a review soon if the GP emphasises that it is an urgent referral.
And again since no one has actually mentioned a single doctors name-I reccomend that your mother check with her GP to see if he/she is aware of which private specialist is available.

I am not accusing your of doctor hopping or anything. I am only trying warning you that some information that have been offered in this thread are misleading and highly speculative.


Posted on: 2009/11/19 6:42
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Re: Which Specialist to see?
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If I am a doctor, I would have all the experience to diagnose. those were just suggestions and ideas and one can never simply trust any opinion from the internet. I don't think an engineer will simply trust a sentence. One will do further research on it. One should take every opportunity to learn new things too.

Furthermore, one does not have to resort to badmouth the other just like what our current politicians are doing.

Yes I agree with luminoth that if she develops pain while eating fatty stuffs, then it could be gallstones as fatty food would stimulate more bile production (to break down the fats) and excessive bile will lead to bile formation. the pain occurs when the gall bladder (bile storage place) contracts to release the bile into the GI tract and is blocked by gall stones at the outlet. An ultrasound of the abdomen is good but it is operator dependent and doing ERCP is not without any risk.

Well, I think Timberland doctors are competent to treat your mum.

Anyways, since normah has a website, here you go.
http://www.normah.com.my/cgi/drlistdsp.cgi

God bless!




Posted on: 2009/11/19 16:51
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Re: Which Specialist to see?
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That is the exact reason why you should be wary of what you say because you are not a health professional and you neither have the expertise or the ability to apply medical knowledge and dignostic skills to help people. And copying whole paragraphs from medical textbooks/websites does not constitute giving appropriate opinion. Are you willing to take responsibility for your advice and your differential diagnoses?

I will not argue any further on this issue. Stormpike I hope you take my suggestions into consideration and jingpeng I hope you consider the consequences to the patient before you dispense medical advice.


Posted on: 2009/11/19 18:11
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Re: Which Specialist to see?
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It was a complete utter rubbish.

We went to see a gastroenthrologist at TMC. He suspected it to be Irritable Bowel Syndrome. But still he referred the case to neurologist because of the fainting, which he can't explain. Neurologist recommended to do a CT scan. Results came back revealed nothing. Neurologist suspect it was epilepsy?

That is a complete utter rubbish. I may be an engineer, but I know what epilepsy is. Why does my mum need to be treated for epilepsy? That is bizzare.

Posted on: 2009/12/18 19:47
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