Russian medicine

[Elen]

      The simple skin polyps I am talking about are definitely within the scope of practice of even the most basic physician.  The problem is not that they don't have the equipment or skill to remove them, the problem is that they have the wrong idea about the nature of these polyps.  In short, they don't know what the heck they are talking about.
   

That's WHY conclusions should be made by CANCER SPECIALISTS. Their consultations are for free , people just should have some will-time -brains to find a way to their offices

[Daveman]

Well, I can't possibly know as to whether Ukrainian medicinal practices are good or bad.  I would merely point to the fact that when the President needed treatment for his serious emergency, he flew to Vienna.  Could have been due to fear that someone would make another attempt on his life at a local hospital I suppose.

Yes, Scott, I understand the point about American muleheadedness concerning all things American being superior, and as most of use here realize, this "American Superiority" could not be further from the truth.  Some things are better, some are not, and some are simply more easily understood and perceived as superior due to familiarity of that which one has become accustomed.

I think one of the problems is that any attempt at logical discussion tends to result in a perceived attack against Ukraine or Russia.  I made a comment once that I thought it was a bit silly that there was no hot water from the tap during spring and summer, and somehow this became "David doesn't like Ukraine".  Non sequiturs can run rampant sometimes.

Elen, here in the states, there is also the difference between cosmetic and medically necessary, and our insurance system rarely will pay for cosmetic. Perhaps there is simply a difference of applied definition for these standards in Ukraine.

Dave

[ScottinCrimea]

     I was removing these types of lesions as a third year medical student, so that will give you some idea about how simple they are to diagnose and treat.  My point is not so much how these are treated, but more the information they are given that removing them will spread cancer to the body, which is 100% false and beyond the comprehension of anyone with even a very basic knowledge of the skin.  ALL of these people had gone to the clinic to have them checked and ALL had chosen to not have them removed based on what they had been told there.  I don't think any 20 year old girl would choose to walk around with  "mushroom" sticking out of her neck if she felt she had any other options.
     As for criticism of the Ukrainian/Russian medical profession, I also have complaints about Western medicine and its shortcomings as well.  I think the difference between us is I will gladly agree with the criticisms if justified and not take personal offense.  I also have been impressed in many cases by physicians here and their ability to do what they do with such limited resources.  Having toured the hospitals and seen their outdated equipment, if any. I have made efforts through various channels to provide new equipment from the US to meet their needs.

[Elen]

Ok le move so something else from your lovely topic about lesions

Of course there are many thing for  criticism in Ukrainian/Russian medicine ( though next time you decide to open a topic with critic of Ukrainian medicine you familar with  would you be soo kind not to name topic Russian medicie  )
 Also no need to blame Ukraunian/RUssian CONCEPT about medicine for stupidity of people who pay less attention to their owm health prefering to blame local doctor instead of using chances to get proper treatment in PROPER places ( I'm not about private clinic I'm about free of pay specialists in particlar spheras) I bet that your 20 years old girl with "mashroom" at her nose ( if such exists at all , but presume she does) just too lazy to visit skin clinic



 

[Elen]

  I also have been impressed in many cases by physicians here and their ability to do what they do with such limited resources.  Having toured the hospitals and seen their outdated equipment, if any. I have made efforts through various channels to provide new equipment from the US to meet their needs.

 Ok you have next 4 pages to prove that you are "objective" boy but not that one who has a joy in pointing finger at FSU problems  Let tell us stories how many skills Russian doctors who work in conditions of lack of medical equipment possess vs American doctors who are just helpless without their electronic

PS Just concentratel exactly at Russian doctors skills but not at YOUR charity 

[ScottinCrimea]

First, I didn't name the topic, and second, most of these people I am referring to were from various parts of Russia and were here visiting Ukraine.  It is unfair to call these people stupid or lazy as many were professionals.  They had gone to their physician and believed what he had told them.  They had no reason to believe that they were not getting proper care so felt no reason to look elsewhere. I point fingers at problems whether I see them in the FSU, the US or the moon for that matter.  I also give credit where credit is due.  My thinking isn't so "cemented" that I take offense at criticisms of anything American or take joy in criticisms of anything Ukrainian.  I have chosen to live in Ukraine so obviously I see a lot of good things here.  Your refusal to consider that perhaps you are wrong in the face of overwhelming evidence and your inferior knowledge of the subject in question shows either an immature nature or that "I refuse to consider other possibilities no matter what!" mentality that some have noted as a possible negative trait of FSU women.
     In a later post I will talk about the issue you describe of American physicians who are helpless without their "electronics" because in large p;art I tend to agree with you and have commented on that before.  Perhaps you can reciprocate and tell me about some of the negatives you see with Russian physicians and the positives that you see with Americans.

[Elen]

1. Sorry I went to first post saw it was yours and though that name of topic was your idea And from your post I got an idea you worked in Crimea and had experience exactly with that place

2. I call stupid and lasy "patients" but not doctors because in many cases problems are exactly in them how ever "smart" they could be in other occupations. ( for sure people who were told that they had something which could turn into skin cancer  should find a time to check that getting consultation from specialists exactly in that skin cancer sphera You told those pacients got advices only from physicians  That's silly behavioure I think)

3. You may tell what you see. I tell what I see here. If I see that your  бородавки  could be healed in 5 minutes here and there are an ocean of clinics which offer that service and you claim that Russian docotos in principle matter refuse to heal them I can only get an idea how you yourself cemented in your preductions

4. I'm off to my real life just now When I return I count to find those 4 pages with your blaimings american concept of medicine ( let it be that proof of your objectivity at least  as I suspect you could not find stories for 4 pages about good russian doctors  )

Bye , darling See you later


PS Till now I was such a lucky that I had only positive experience with Russian doctors - it was not much problems with my health , it was saving a life of my mother by sending her to cancer spesialist in time to get proper , good and free of pay surgent, it was that "skin specialists" in a case with my daughter when she got that ugly "thing" ( after damaging aciendly that little spot on her apper hand)  which appeared thank god only gemangioma ( was treated in 10 minutes in loical polyclinic after tests made in cancer center - for free. The only troubles I had were with greedy dantists

[ScottinCrimea]

     You don't seem to understand, so I will try once more to explain about these patients.  They were not lazy because they went to their physician about these lesions.  They were not stupid because they knew enough to be concerned and have them checked out.  Their problem was that they trusted the wrong information that these doctors told them.  They were told that these might spread cancer ONLY if someone tried to treat them by removing them.  Based on this wrong information, the smart thing for them was to leave them alone and not have them treated.  It is not that the doctors refuse to treat them it is that the doctors were taught WRONG.  The fact that so many doctors were telling patients the same things suggests a huge weakness in the medical education system in Russia, since this thinking is contrary to the medical thinking of any other country that I have had experience with.  They were only doing as they had been taught to do.  You continue to completely misunderstand and misquote what I have written to try to support your side.
     I am happy you have had positive experiences with Russian doctors.  This could possibly be because you don't have enough medical knowledge to know if something they did was unnecessary.  For example, a hemangioma doesn't require cancer tests before treatment, so your daughter may have been subjected to unecessary pain and delay in treatment because of this extra step.  Not knowing this sin't necessary, you wouldn't think anything different.
     Now, as for American medicine:  My internet isn't working well right now and \i have to close, but I will write my concerns in a couple of days when I get this fixed.  IN the meantime, I didn't hear anything from you about what is good about American medicine.

[Elen]

It is not that the doctors refuse to treat them it is that the doctors were taught WRONG.  The fact that so many doctors were telling patients the same things suggests a huge weakness in the medical education system in Russia, since this thinking is contrary to the medical thinking of any other country that I have had experience with.

It's not a FACT at all that those doctors have been TAUGHT so The fact is only it's what you have been told by people you met ( not doctors) - nothing more. ( it even is not a fact those people did hear such conclusions from their physicians but nor just re-telling "rumors" in a way   слышу звон, да не знаю, где он THTA is very common among our people) 
  How many other  doctors think the same it's only your guessing but not a FACT at all. If you were familar exactly with educational programm in medicine Univercities here  then you could speak about wrong concept
 But if you are not familar with it then it's only your personal opinion based on limited as well experince about such global thing like concept of medicine in Russia .
 I would be fine with your claiming that people you met had wrong ideas about medicine But to speak about whole wrong Russain concept is  something too much for you


PS If you could see that tumor on my daughter 's arm then you could give your consultation how it was supposed to treat ( I just bet you can't to describe how it's supposed to look like because her case was really unusial)  As for me I trust cancer specialists from federal cancer centre ( who are dealing with such things on daily basis)  more than family doctor. ( who hardly saw such cases at all)
( BTW she was sent to that cancer centre exactly with "gemangioma" diagnosis ( but under question)  made by surgeon in local polyclinic)

They were only doing as they had been taught to do.  You continue to completely misunderstand and misquote what I have written to try to support your side.

You continue to do the same. ( as well as you are doing only like you have been taught to do )

   

[Zhena]

- - - - -

Zhena, Scott is a MD with 12 years of medical school, so I think he probably knows best about this.  But, I do hope that he responds to your comment.

Well I am a doc with just 3,5 years work experience so I believe I can talk about something too
What I heard from the russians in america who deal with the doctors,that the surgery is on the high level here,but not the physicians Personally me got an experiance only with the dentistry-and I dont see any difference with Ukraine-just 10 times higher price...In the future I will treat my teeth only in Ukraine.

[Zhena]

To be honest, this does sometimes put a strain on things because it is difficult to feel that my knowledge is not respected, but I realize that she has never seen me in my home environment so I think she sometimes judges my knowledge by my limited ability to explain things in Russian and her limited ability to understand me in English.  Medicine has its own unique language.  I know when what I say has gotten across to her, though, when I hear her telling it to others.  She has also witnessed the excellent results \i have gotten helping some people here when the locals have failed.  Most of the time, if what she is doing isn't causing any harm, I just keep silent.  Besides, most of what we do as doctors is to give the patients something to keep them busy until their body heals itself.

Now, in response to Zhena's comments:  While cupping is practiced in many areas, there is still no scientific evidence that it works.  Like astrology, just because it's practiced by many people, doesn't mean it has any basis in fact.  As for oral medicines versus injections, you could use the same arguement that you lose some medicine into the muscle that never reaches the blood.  There is a thing called the "first pass effect" which means that a certain amount of a drug is lost through filtration by the liver before it ever reacts with the body.  This, as well as any losses through the GI tract are taken into account when the dose of a drug is determined.  This means, for example, that you would use a smaller amount if injected directly into the vein versus into the muscle.  So the end result is that a medication taken by mouth is just as effective as a medicine taken by injection.  The only advantage to the injection is that it begins to work a bit faster.  Other than in emergency situations, the difference in time isn't important.  Isn't modern medicine wonderful?

Scott,I just started to read the pharmacology-american pharmacology. And there is said what I said-the injections more effective. There even a diagram,maybe I will post it here if will have a time.

[Zhena]

I have run into one idea in Russian medicine that makes me crazy.  I'm sure Mir would appreciate this.  Everywhere I look I see people here with very unsightly fleshy polyps that they have had since birth.  The doctors refuse to remove them because they say that they might have cancer inside them and if they remove them it will spread the cancer to their bodies.  Yesterda a friend of my wife's came over to visit.  She showed me two small polyps on her back and told me that her dactor had said that she must not do anything to irritate them such as take a mud bath because it will cause the cancedr in them to spread.  I assured her that this is just nuts and told her next time she comes all I need is a little lidocaine and some sharp scissors and I will have them off in 10 seconds.  My wife showed her where I had removed a small one from her thigh with no scarring and no terrible afteraffects.

Whaaaaaaaat?  I never heard of that before...Do you live in a small village? Just wonder,cos where I lived,I never heard something like that. My boss was removing different polyps all working day long. Maybe those people just should go to dermatologist?

[BC]

Scott,I just started to read the pharmacology-american pharmacology. And there is said what I said-the injections more effective. There even a diagram,maybe I will post it here if will have a time.

I have noted that here in Europe, injections seem to be preferred but guess what.. the doc won't usually give an injection.. It's up to you to find someone to give you a shot... I am so happy though that my RW was well versed and can give shots like most of women around here.

A couple years back, I had a really painful toothache and visited the ER.  They put me on IV with lixidol then sent me home.  Luckily one of the techs I knew felt sorry for me and passed me a box of 'goods' when I left and told me I could either drink it or have it injected (guess where lol)..

On the way back, wifey insisted we buy some syringes at the local grocery store. I protested but finally gave in to keep her quiet.  I first tried drinking the stuff but the effect was quite short lived and finally submitted, dropped my drawers and let wifey take aim.

It worked much better and longer that way.

That's about all I can say about this topic 

[LEGAL]

Scott is there any way you could help Elens daughter?

LEGAL

[ScottinCrimea]

     My experience with this topic was based on the fact that 100% of the people who had this problem told me that they had been told the same thing by their doctor.  These were people from Moscow and Kiev as well as smaller cities, not only villages.  Perhaps somewhere doctors are saying different, but based on my experience I had to conclude that there was a problem with medical education on this particular topic.  I don't even want to begin to discuss "ostochondros" (osteochondrosis) which is a bony disease of the joints of young dogs and horses and can also be found in the aged and those with severe arthritis which seems to be diagnosed in every patient young or old who complains of joint or back pain.
     Now, to the topic of injectable versus oral medications, why don't we let the World Health Organization have the final word?  In a study done by them, they identified one prevalent misconception among both patients and many physicians was that, "Injectable drugs are 'stronger' than oral drugs".  The conclusion of their study was the following:
     There is minimal to no benefit of IM versus oral administration of drugs in terms of pharmacotherapeutics.
     IV administration results in shorter onset of action and for some drugs higher bioavailability and peak serum levels.
     The issue of onset of action is clinically relevant only in life threatening emergencies.
     The pharmacokinetic advantage of parental over oral drugs does not translate to better clinical outcomes in mild-moderate illness.

It sounds to me like they are repeating exactly what I posted before.  In addition, they identified significant risks with injections versus oral administration of drugs.  They report that 37% of Hepatitis B, 40% of Hepatitis C and 5% of HIV cases are the result of injections.

For those of you who aren't familiar with the term hemangioma, I'll discuss that now.  By definition, hemangiomas are an abnormal build up of blood vessels in the skin or internal organs.  Hemangiomas are usually present at birth, although they may appear within a few months after birth, often beginning at a site that has appeared slightly dusky or differently colored than the surrounding tissue. Hemangiomas, both deep and superficial, undergo a rapid growth phase in which the volume and size increase rapidly. This phase is followed by a rest phase, in which the hemangioma changes very little, and an involutional phase in which the hemangioma begins to disappear.  Hemangiomas are one of the most common birthmarks in newborns. Most hemangiomas are not present at birth but develop within the first few weeks to months of life. They are found in up to 10 percent of babies by the age of one.  Hemangiomas usually involute (shrink away) in time. 30% of hemangiomas will resolve by 3 years of age 50% by 5 years of age, and 80%-90% by 9 years of age. Over one-half of hemangiomas heal with an excellent cosmetic result without treatment.
     So, in summary:  1) Up to 10% of babies have these 2) 90% will disappear on their own without treatment 3) In no cases is there any relation between cancer and hemangiomas 4) The diagnosis is based on physical examination, not lab studies. 5)Given the location on Elen's daughter's arm, there is no risk of complications other than cosmetic ones.
     Now let me say that it can be quite traumatic to see such a lesion on their child and they worry that their child will not appear "normal" so they tend to be quite anxious and demand that something be done, even if this involves discomfort for the child.  Most do not want to wait for it to take its natural course and disappear on its own. If indicated, most are treated with laser or injections of cortisone.  Surgical treatment is only indicated where there may be a significant cosmetic issue.
     Now a quick comment about dentistry here.  I have been very impressed so far both with the quality of care and the instruments used.  I have no hesitation about being treated by dentists here and have done so in the past.

[LEGAL]

     Now a quick comment about dentistry here.  I have been very impressed so far both with the quality of care and the instruments used.  I have no hesitation about being treated by dentists here and have done so in the past.

Olga  :hairraising:

[Mir]

Scot

You are right about haemangioms that they are benign neoplasms of the cells that form the vessel walls.
Rarely rapid increase in size can lead to ulceration and infection that could be quite distressing.

Anyway in Ukraine there is a distinction between a dermatologist and a cancer specialist(who treats skin cancers as well). In UK and USA the dermatologists are supposed to be the specialist who treats skin cancer.

Important to remember that the vast majority of skin cancers are not life threatening and it is extremely rare to encounter a skin cancer in a child.

[Zhena]

Scot

You are right about haemangioms that they are benign neoplasms of the cells that form the vessel walls.
Rarely rapid increase in size can lead to ulceration and infection that could be quite distressing.

Anyway in Ukraine there is a distinction between a dermatologist and a cancer specialist(who treats skin cancers as well). In UK and USA the dermatologists are supposed to be the specialist who treats skin cancer.

Important to remember that the vast majority of skin cancers are not life threatening and it is extremely rare to encounter a skin cancer in a child.

Right. We usually diagnosting it visually and send those patients in the cancer center to make the lab diagnostic to confirm. And if its a cancer,they treated by the cancer specialists in the future.
About hemangioma-yes,its mostly cosmetic defect which many people dont want to have. My niece had that also-and she was cured by laser when she was only a couple months old. My sister just didnt want that on her daughters arm. The procedure is very fast and easy,so no problem with that.
About the different papillomas,the dermatologists just remove it themselves. Though in the most cases the equipment is bought on the own doctors money,if its not a private clinic.
The family medicine now developing in FSU,but my personal attitude to that is negative some-I consider that one person cant know everything perfectly. Usually they get the superficial knowleges.

[Elen]

Okay Not in my rules to tell my personal stories but I told already you American know-it-all doctor has not seen our case. What you wrote was right about flat skin hemangioma In our case it was not such a kind

First it was just like a dot after injection at a place where vaccination has been done ( We are not sure (as well as doctors) about if it was really after vaccination or not It's only daughter's words and to time when it all happened about 2 years passed since the last vaccination)

Then "some" day we just notice an acne ( not flat) at her arm - a little one - not more than 2mm But it was odd dark lillac color We tried to force her to show that to a doctor but for long time it was only " Yeah, Yeah I'll visit a doctor tomorrow" Untill one day she anciently broke that spot in a  bathroom and she had already to "run" to a doctor because we could not stop bleeding ( And it was not just a drop bleeding but rather a stream)
Surgeon in local polyclinic told it's hemangiom most probably but consultation from cancer specialist was in demand.  To that time ( in couple days) when we got to cancer specialist a spot turned into 10 mm tumor ( above surface) of the same red-lilac color To that time when tests in cancer centre have been ready ( about 2 weeks)  tumor was about 2,5 sm.  Just a "plumb" on "a leg" at upper arm ( though no "color" on a skin around a base of that "leg")  And constantly bleeding in addition. Of course it was impossible to leave such a "cosmetic" defect
 Thank god it was really only a hemangioma without any cancer cells It was just cut off.  Scar does remain but really it's "nothing".

What caused it we still don't know Doctors say it could not be vaccination ( I don't believe in that too but daughter is sure it was exactly at a place of  injection)

And I really had no claims to Russian medicine in that case.
-----------------------------------------------

  Fine topic about polyps, liasons and hemangioma - that's always so in a case with doctors   I had a uncle who was a doctor too and could not speak with his friens at family table about something else but purulent abses  

[Zhena]

I suppose it might be a pyogenic granuloma.
Pyogenic granulomas are 5-10mm soft red papules that bleed easily with minor trauma. They are most common on the skin but may also occur on mucosal surfaces or,rarely,within blood vessels. Granuloma gravidarum is a variant that occurs on the gingiva during pregnancy. The pathogenesis is unknown,but approximately one-third will occur after local trauma.

[Mir]

Zhena

Doctor I agree with your diagnosis

When there is history of trauma it is always minimal like an insect bite. In this case vaccination was the trauma.
Pyogenic granuloma is also called 'lobular capillary hemangioma'

They are always benign and will not be managed by a cancer specialist in UK.

[Elen]

well aesculaps you may manage your patietns like you wish As for me in cases if something( whatever it could be called) grew at a place where it's not supposed to be I prefer to get a test which whould proove there is nothing else inside. That;s better than be "sorry" because doctor has not seen caner cells with "eye" Mistake would  cost a LOT
( BTW as far as I'm aware each "thing" wich was cut off - even if there was all obviouse from first sight and there was not consultation from cancer specialists - is supposed to be sent to biopsy test in any way. That what I was told)

(Ps vacination was more than 2 years before But I'm not going to discuss what was a "reason" truth tell I 'm just happy it's all in past)

[Mir]

You are right all things that are removed are sent for examination to make sure they are benign.

[Elen]

You are right all things that are removed are sent for examination to make sure they are benign.

That means only
1. mistake coudl be done in EVERY case however all could be clear from fist glance and check for cancer is alway in demand
2. I am always right

[Turboguy]

That means only
2. I am always right

We all knew that part already Elen.  It is why we are happy to see you back so we can get some information that is always correct.