Are GPs useless?

codeine is also metabolised by cyp450 to morpine
codeine + tramadol = competitive inhibition of cyp450 on metabolism of tramadol into its more active metabolite
 
tamzzy said:
codeine is also metabolised by cyp450 to morpine
codeine + tramadol = competitive inhibition of cyp450 on metabolism of tramadol into its more active metabolite
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Well it seemed to do the job pretty well. Also pretty much knocked me out so I caught up on some sleep too.
 
tamzzy said:
codeine is also metabolised by cyp450 to morpine
codeine + tramadol = competitive inhibition of cyp450 on metabolism of tramadol into its more active metabolite
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The contribution of morphine to it's analgesic effect is questionable.

Personally I'm not a fan of either codeine or tramadol as analgesics.
 
exactly, that's why competitive inhibition of cyp450 by codeine when you take tramadol as well reduces the analgesic effects somewhat
 
InKursion said:
Well, if you're unsatisfied you could always go private...
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The doctors only treat the symtoms and not the problem.

Now that massive money is being made by big pharmacutical companies with regulation by goverments and friends of goverments...there lies the problem.

To keep a lot of people on a lot of medicine creates a lot rich people richer.

There is money to be had from the unhealthy. No money to be made for cures I'm afraid.

Its a multi trillion pound pigs trough out there in making people better market.....
 
In the Uk GPs are Gods - their knowledge is boundless. Why they are the highest paid medics in the World particularly when one realizes their wonderfully convenient working hours and the level of real responsibility they carry. Hospital consultants are blessed with have your cake and eat it contracts wonderful inflation proof pensions ( theirs pension pots are worth millions) and then the prospects of hundreds of thousands a year sucked in from their private patients - all on the back of the National Health Service. Their standards are those of the country in which they work. The prospects of not surviving a heart attach/cancer et al are more than double that in the developed part of Europe and that includes Spain. I advocate people going to Germany for treatment.
 
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powlesY said:
I got a call from the hospital this morning about the chest specialist. I was told i'd have to wait maybe 6 months but they've booked me in for next Wednesday - i don't know if going to A&E made them speed up the process a little. Like i've said before though, since i've gotten out of the room it's only my chest that feels to have detoxed/gotten a bit better. But i guess explaining things to the chest specialist might still move things along in terms of other symptoms and he may be able to rule out my chest completely. If not, he finds something and i finally have a potentially accurate diagnosis.
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Hang on, so what happened to your 'wasted journey' then, I thought you said they basically told you to '**** off'. When in fact you've been referred to a chest specialist. Nothing like a bit of exaggeration for effect huh. Actually it's not exaggeration, what happened is the exact opposite of what you told us. :rolleyes:
 
powlesY said:
I got a call from the hospital this morning about the chest specialist. I was told i'd have to wait maybe 6 months but they've booked me in for next Wednesday - i don't know if going to A&E made them speed up the process a little. Like i've said before though, since i've gotten out of the room it's only my chest that feels to have detoxed/gotten a bit better. But i guess explaining things to the chest specialist might still move things along in terms of other symptoms and he may be able to rule out my chest completely. If not, he finds something and i finally have a potentially accurate diagnosis.
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Google Coeliac disease!!
 
Energize said:
The contribution of morphine to it's analgesic effect is questionable.

Personally I'm not a fan of either codeine or tramadol as analgesics.
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I haven't used codeine for years and neither do a lot of my friends. In paeds there is no excuse for it and I don't think you find it used in Toronto, GOSH, etc. However, I had to correct a reg last year who deemed it appropriate to use with 60mg/kg paracetamol on a 4/12 4 days after open heart-surgery ... don't think he'll do that again.
 
Doohickey said:
Hang on, so what happened to your 'wasted journey' then, I thought you said they basically told you to '**** off'. When in fact you've been referred to a chest specialist. Nothing like a bit of exaggeration for effect huh. Actually it's not exaggeration, what happened is the exact opposite of what you told us. :rolleyes:
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No, no. They didn't do anything whilst i was there and just got rid of me. I mentioned early on in the topic that it took over a year for them to refer me to see anyone and that i have to wait a further 6 months for it.

The phone call i got could've been mere coincidence that it was just after i'd been to A&E, or they might've had a quick look at my file after i left and pushed me up the list. I don't know how these things work.
 
marmalade said:
In the Uk GPs are Gods - their knowledge is boundless. Why they are the highest paid medics in the World particularly when one realizes their wonderfully convenient working hours and the level of real responsibility they carry. Hospital consultants are blessed with have your cake and eat it contracts wonderful inflation proof pensions ( theirs pension pots are worth millions) and then the prospects of hundreds of thousands a year sucked in from their private patients - all on the back of the National Health Service. Their standards are those of the country in which they work. The prospects of not surviving a heart attach/cancer et al are more than double that in the developed part of Europe and that includes Spain. I advocate people going to Germany for treatment.
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If you want to cherry pick figures to prove **** all how about we compare the prognosis and inefficient renal services in Germany with their poor uptake of peritoneal dialysis and low live-related transplant rate compared to the excellent service offered in those regards in this very country by the NHS.

Next time try backing up your waffle and I can quite happily show you where you are going wrong. Or will you do a cut and run like Dolph the other day where he went all quiet when I pointed out to him his figures were 7 years out of date and kind of irrelevant.
 
If you can afford it go to Germany. The fees charged by specialists and of course GP's are much less than the uk - some even have 0800 telephone number. How many French, Dutch, German Dr's can one buy for the price of one of these UK Gods with the sort of hours and responsibility that are beyond belief? A large Hospital such as the UKE (Uni Klink Eppendorf) Hamburg covers every which sort of health area with the latest equipment da Vinci robots / in the blink of an eye scanners (Siemens) and otherwise. The sort of waits experienced in the UK just do not exist. In fact the hospitals ( which surely must be the most expensive in the World - look at the Billions spent on management consultants - if one did not experience the situation one would not believe it possible )in general bear absolutely no resemblance to the shambolic medical slums that pass as hospitals in the UK. Gp's have for many years use the hospitals as garbage disposal units to clear their surgeries - undertaking none of the basic procedures that their continental colleges form Developed Europe do. I called in on a friend a few months ago and he was delighted to have managed get to actually syringing an ear !
UKE have a busy A&E but only for emergency cases!!!! and for which a Euro health card is necessary
 
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