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Serious Heart Bypass advise needed

johnny333

Alfrescian (Inf)
Asset
When someone like me with just a dip in technical field can correct amd educate 4 doctors (as far as I can remember) from polyclinics, hospital and gp, what else can u expect from our medical professionals :*:


I heard that the situation in Spore has gone down hill. I used to visit my own GP but I think he has now retired?

When I was working I used to get sick very often but nowadays I rarely get sick. The last time I had a cold was a few year ago & it lasted only 2 to 3 days.
Except for chelation & EECP treatments I have not visited a GP in 10+ years. This is because I am now more health conscious : taking many good supplements, watch what I eat, avoiding sick people,...

Nowadays there are many good books in the library about health & I think it is essential to educate ourself because it is always better to avoid seeing a doctor because what they prescribe can be harmful e.g. antibiotics. If you don't have time can get info from the internet, e.g. the Life Extension Magazine http://www.lifeextension.com/magazi...LvkP5HtCcLyAKuAePrfw6_fOHW9164-uG0xoCo-Lw_wcB
 

nayr69sg

Super Moderator
Staff member
SuperMod
Where's our resident doctor? He is always honest and straight to the point.

Sorry Sam, I was just waiting till the thread got some semblance of rational discussion.

First and foremost, you have to understand that in a heart attack (ie acute myocardial infarction), the heart muscle is ACUTELY starved of oxygen and start to die (infarct). This usually happens because of a clot forming in the coronary arteries. You can actually have very minor coronary artery blockage or major coronary artery blockage on an angiogram and still have that clot forming. Often it is because of a cholesterol plaque rupturing and the clot forms on it. This is for heart attacks. The ones that kill you.

Angina is where coronary arteries are blocked. If you stress your heart and increase its oxygen demands, the coronary arteries may not be able to supply the blood flow and hence oxygen to the heart because of the blockage. Increase demand, supply cannot keep up. The heart starts to feel painful (angina) due to this. You stop running or stressing, the demand drops, the supply is enough. The heart muscle recovers. This is what treadmill tests detect.

Now the treatment for someone who is ALREADY in myocardial infarct ie heart attack can be angioplasty. They go in and balloon away to clot blockage. Put in a stent, save the heart muscle. Or it can be use of blood clot busters fibrinolytic drugs given intravenously. This is a life saving procedure. If you are already having a heart attack you will die in a couple of hours. So the discussion for that patient is probably not in this acute emergence situation. This one, talk about coq10 and red yeast rice extract no point lah. Sure die. Ok so that is emergency. Having heart attack. Of course if saved, and found many other vessels blocked etc, can also discuss coronary artery bypass graft (CABG) later.

Now what is also common is a guy is worried about his heart. Goes to a cardiologist and says he wants to check it out. Or has some chest pain and wants it checked. Do treadmill. Unsure or positive result. (Most private cardiologists in Singapore will say unsure). Then offer angiogram. Now when you do an angiogram there is a risk of having a stroke or heart attack. Small risk ( I dunno the numbers). But it is there. This is why it makes no sense to do it on a healthy young man. He is ok good, you go do angiogram then he kena stroke or heart attack. Is that acceptable? Of course not lah. So usually will do treadmill if show some signs then do. Or if the patient insists and still accepts risks (obviously he must be symptomatic or have strong family history, smoker or something to justify the off chance of stroke and heart attack) then we'll do it. There are those Heart MRI/CTs but I really dunno too much about the evidence behind it.

Anyway I digress. The angiogram is usually scheduled with consent taken and also consent for stent if they see a "significant blockage". Reason being is that if you do angiogram once you got that risk of stroke and heart attack. You do it twice your risk doubles. So cardiologist will say, if I see block I straight away put in stent ok? Save you the 2nd angiogram and risk again. Smart marketing tactic also by the way. Now what is "significant" depends on the cardiologist lah. I mean really he is the one that reports the angiogram and the % block and also the one who puts in the stent. In private sector, who will check on the cardiologist? In public sector got more checks and balances lah.

Now bypass surgery is when the blockage is too long for a stent. Imagine the whole vessel all blocked all the way. Or segment very long. Or so many vessels blocked. Then using a bypass graft is an option. There also also other indications where I cannot remember exactly about the studies that show that stent in patient with diabetes usually do not do well or is it vice versa. I am not a cardiologist so you best listen to the experts on those small details.

So Seee3 is in some sense correct when he talks about people who are still walking around despite 100% blockage. This is because of neovascularization. If the blockage process is gradual enough, the heart learns to produce new coronary vessels that will "bypass" the blockage itself. They tend to be very small and sometimes cannot be detected on an angiogram.

I suggest anyone having coronary artery vessel problems consult a cardiologist.

Those people who have heart failure, that is when the heart fails in its function as a pump. It is a total different discussion. CoQ10 is supposed to have some benefit for patient with congestive heart failure. Not coronary artery disease. Although one of the causes of heart failure is previous coronary artery disease or acute myocardial infarction.

Chelation therapy has not been proven in clinical trials but there are lots of anecdotal reports. I once worked with a guru in alternative medicine. I ran his regular clinic and he did all the alternative stuff. It was under him that I also got my fellowship in applied clinical nutrition. This therapy is considered experimental and doctors are not allowed to offer it without a special application for a research trial.

I have read all the criticisms about doctors not learning nutrition and all that.

Well here's the thing. In Singapore, family doctors are paid so little for consultation. It is not time based either. In fact most patients have no idea what "consultation fees" are. To them go doctor is to buy medicine. Hence all the jacked up medicine prices. It is to make up for the low consult rates. When it comes to these nutrition and alternative stuff, the only way you can profit from it is by selling the nutritional products or offer "illegal treatments".

I found that all those nutritional products so to speak.....well guess what, they are more expensive than your medications. It sounds very nice to seem like you are "smarter" than everyone else cos you take all these "special" products that other doctors don't offer their patients. Yeah but you pay way more also. And on top of that there is no evidence for it.

I could not in good conscience sell to average HDB heartlanders these products that cost 10 times more than the conventional medication which they already were not keen on taking. So really this whole "alternative" treatment to me is just a play on the rich. Make them feel special. They take this special treatment while the poor cannot. In the end there is no difference as Sam said we all have to die.

Oh yes, and if you are thinking "I have the last laugh cos I take all these special nutrition, exercise regularly and my risk of heart disease is near zero" , well guess what, it is VERY LIKELY that you are gonna die of cancer. I am very serious.

Excessive exercise ( I cannot remember the definition) eg running marathons weekly that kind of thing, produces lots of free radicals. These can damage cells. This is why often these highly fit individuals get cancer. Next time just watch your friend who is that fitness freak with little body fat and very fit. See if he kena cancer in the end. And in some cases when they are young. It is devastating to them. Because they worked so hard thought they were the epitome of fitness and health and then cancer strikes. They cannot understand it.

As a doctor, one has to decide what path they want to go on. I chose the conventional path. I can be a good salesman, but I rather stay on the side of the law. My quest for knowledge is to understand my patients. Those who think they will know more than me, will find out otherwise. But it helps with the overall conversation. TCM is another branch.

Family doctor in Singapore hard life. Everyday see cough and cold sell antibiotics. Consult fees like $5-$10. So quickly see, quickly sell antibiotics. Who willing to pay $250/hr for me to explain all the nutrition stuff to them then spend another $1000 a month on all the super supplements?

Talk is easy. You try doing as a doctor lah. Cars and houses expensive in Singapore leh!

Life is way better in Canada.
 

chootchiew

Alfrescian (Inf)
Asset
I heard that the situation in Spore has gone down hill. I used to visit my own GP but I think he has now retired?

When I was working I used to get sick very often but nowadays I rarely get sick. The last time I had a cold was a few year ago & it lasted only 2 to 3 days.
Except for chelation & EECP treatments I have not visited a GP in 10+ years. This is because I am now more health conscious : taking many good supplements, watch what I eat, avoiding sick people,...

Nowadays there are many good books in the library about health & I think it is essential to educate ourself because it is always better to avoid seeing a doctor because what they prescribe can be harmful e.g. antibiotics. If you don't have time can get info from the internet, e.g. the Life Extension Magazine http://www.lifeextension.com/magazi...LvkP5HtCcLyAKuAePrfw6_fOHW9164-uG0xoCo-Lw_wcB

I'm not sure how many people are aware of this situation. I used to think highly of doctors long ago, until when I need to accompany my aged parents and myself for numerous doctor consultations.
I finally realised most doctors (but not all) are just like anyone of us with an average ats (analytical troubleshooting skills)
Honestly I only admire surgeons who do hands on surgeries to fix problem or save lives. Other than that are all close to "pian jia" .
 

nayr69sg

Super Moderator
Staff member
SuperMod
Here's the thing with Sinkaporeans.

They read some book they buy in the bookstore about the hidden secrets to heart health written from an alternative medicine perspective, maybe listen to some MLM talk with some overseas "specialists" talking about how great their health product is. The books and talks regularly tell people that this info - their doctors will not know. Yup cos they know the doctors are never taught these things which are not evidence based.

So they go see their doctor, smugly ask them if they know XYZ and the doctor say dunno. And the patient thinks "I know more than this doctor".

Cock lah.

Medicine is a highly regulated profession because it needs to be. Otherwise you get all kinds of people selling snake oil.

I had many friends who were part of MLMs, read all kinds of books, talk to their customers like they are doctor like that. But if anything goes wrong they will say "sorry I not doctor, you better go see your doctor". Fish man.

So what, people only respect their doctor if he knows all this crap about nutrition and alternative medicine? But when push comes to shove ask you buy the expensive supplements you say errrr.....so expensive.

In Canada, the doctors also dunno about all this alternative stuff. I mean seriously, why you want to teach stuff that is not proven? You really want you doctors selling snake oil? But in Canada people respect the doctor for his/her conventional medical knowledge. Not alternative medical knowledge.

For that you can go see the naturopath. But again if anything goes wrong, they have no tertiary centre to send you to where they can resuscitate you with some compound diluted to a million parts (Homeopathy) or get you to drink your own urine (auto-urine therapy). They will ask you to go to the A&E and see the doctors you despise.

It takes two hands to clap. It takes a trusting patient and a faithful honest doctor to have a good health care system. There is none of either in Singapore.
 

nayr69sg

Super Moderator
Staff member
SuperMod
I'm not sure how many people are aware of this situation. I used to think highly of doctors long ago, until when I need to accompany my aged parents and myself for numerous doctor consultations.
I finally realised most doctors (but not all) are just like anyone of us with an average ats (analytical troubleshooting skills)
Honestly I only admire surgeons who do hands on surgeries to fix problem or save lives. Other than that are all close to "pian jia" .

I rest my case.

Anyway I know what you mean lah. I am frustrated with the profession also. See, medicine is not about actually fixing the patient and getting results. It is diagnosing and then following guidelines do what is recommended and stay safe.

If a doctor tries to think out of the box, put on the analytical cap and use unconventional means to solve the problem and see if there are results - the doctor is called a quack. and if something goes wrong, sued till pants drop.

Seriously which doctor wants to do that? For what? If the doctor manage to cure your illness with some crazy new he-cook-up-himself treatment you are going to pay him what? $1 million dollars? $100,000? $10,000? $1000? $100? More like "why must pay? he ask me go drink my own urine!" And then if go wrong, all the responsibility lies with the doctor. If you want ATS go see naturopath or TCM lah. Western doctors are not meant for ATS.

Frankly I cannot stand Singaporeans. So glad to have left all of them behind in Singapore.
 
Last edited:

scroobal

Alfrescian
Loyal
I think you see this around the World as well. Thankfully a small minority but big enough to fuel a rapidly growing supplement industry and the alternative medicine industry.

Where Singaporeans and possibly 3rd world culture is concerned, how patients interpret the advice given is also a concern. If you tell them that it is not proven, no evidence or not evidence based, they think or convince themselves that it means that accreditation or certification is a long time coming or worse still the doctor has not read up on the latest.

I met an American lady doctor who began practicing in Singapore in the late 90s. She told me that she has to very direct to locals and avoid Political correct terms.

Here's the thing with Sinkaporeans.

They read some book they buy in the bookstore about the hidden secrets to heart health written from an alternative medicine perspective, maybe listen to some MLM talk with some overseas "specialists" talking about how great their health product is. The books and talks regularly tell people that this info - their doctors will not know. Yup cos they know the doctors are never taught these things which are not evidence based.

So they go see their doctor, smugly ask them if they know XYZ and the doctor say dunno. And the patient thinks "I know more than this doctor".

Cock lah.

Medicine is a highly regulated profession because it needs to be. Otherwise you get all kinds of people selling snake oil.

I had many friends who were part of MLMs, read all kinds of books, talk to their customers like they are doctor like that. But if anything goes wrong they will say "sorry I not doctor, you better go see your doctor". Fish man.

So what, people only respect their doctor if he knows all this crap about nutrition and alternative medicine? But when push comes to shove ask you buy the expensive supplements you say errrr.....so expensive.

In Canada, the doctors also dunno about all this alternative stuff. I mean seriously, why you want to teach stuff that is not proven? You really want you doctors selling snake oil? But in Canada people respect the doctor for his/her conventional medical knowledge. Not alternative medical knowledge.

For that you can go see the naturopath. But again if anything goes wrong, they have no tertiary centre to send you to where they can resuscitate you with some compound diluted to a million parts (Homeopathy) or get you to drink your own urine (auto-urine therapy). They will ask you to go to the A&E and see the doctors you despise.

It takes two hands to clap. It takes a trusting patient and a faithful honest doctor to have a good health care system. There is none of either in Singapore.
 

nayr69sg

Super Moderator
Staff member
SuperMod
No it is not the same around the world.

People in Canada know what the western medical doctor is for.

Alternative medicine is not part of our services. For that you go to the naturopath.

In Singapore, people belittle each other. All those people who cannot stand CCS paper general for acting like he knows everything and is smarter and better than everyone. Singaporeans are no different to each other also lah.
 

chootchiew

Alfrescian (Inf)
Asset
I rest my case.

Anyway I know what you mean lah. I am frustrated with the profession also. See, medicine is not about actually fixing the patient and getting results. It is diagnosing and then following guidelines do what is recommended and stay safe.

If a doctor tries to think out of the box, put on the analytical cap and use unconventional means to solve the problem and see if there are results - the doctor is called a quack. and if something goes wrong, sued till pants drop.

Seriously which doctor wants to do that? For what? If the doctor manage to cure your illness with some crazy new he-cook-up-himself treatment you are going to pay him what? $1 million dollars? $100,000? $10,000? $1000? $100? More like "why must pay? he ask me go drink my own urine!" And then if go wrong, all the responsibility lies with the doctor. If you want ATS go see naturopath or TCM lah. Western doctors are not meant for ATS.

Frankly I cannot stand Singaporeans. So glad to have left all of them behind in Singapore.

Of course i was referring to situaats is applicable. Eg when someone keeps passing mucus, there is a high chance that there were bacteria infection with the intestines, and this was acknowledged by the doctor. .instead of prescribing antibiotics , the doctor advise for other approach first. Only when I asked again can't u prescribe first while waiting for the other test he then prescribe it. Apparently the antibiotics stop the mucus in my case.
 

scroobal

Alfrescian
Loyal
Alternative medicine, supplements and their associated literature began in the 1st world countries. It is firmly entrenched in their psyche. So much so that there is now state controlled certification for some of these in some of these first world countries.

No it is not the same around the world.

People in Canada know what the western medical doctor is for.

Alternative medicine is not part of our services. For that you go to the naturopath.

In Singapore, people belittle each other. All those people who cannot stand CCS paper general for acting like he knows everything and is smarter and better than everyone. Singaporeans are no different to each other also lah.
 

nayr69sg

Super Moderator
Staff member
SuperMod
Mucus in stool? Sign of bacterial infection? Where did you smoke that up?

Anyway here's a secret we doctors do. If you give a suggestion and want a particular course of action eg antibiotics or whatever.....as long as it won't harm you and is not illegal, we tend to just accede to your request. Give you what you want. Then you will get out of the consult room.

It doesn't mean you were right.

Most diarrheal conditions hardly ever require antibiotics. Even in salmonella positive stool tests not all patients require ciprofloxacin.

Excessive mucus in the stools may suggest colon polyps or cancers that secrete excessive mucus. Or ir may just be the colon naturally secreting more leukocytes to fight infections.

Singapore is land of antibiotics. Antibiotics for everything.

ATS my foot.
 

johnny333

Alfrescian (Inf)
Asset
Here's the thing with Sinkaporeans.

They read some book they buy in the bookstore about the hidden secrets to heart health written from an alternative medicine perspective, maybe listen to some MLM talk with some overseas "specialists" talking about how great their health product is. The books and talks regularly tell people that this info - their doctors will not know. Yup cos they know the doctors are never taught these things which are not evidence based.

So they go see their doctor, smugly ask them if they know XYZ and the doctor say dunno. And the patient thinks "I know more than this doctor".

Cock lah.

Medicine is a highly regulated profession because it needs to be. Otherwise you get all kinds of people selling snake oil.

I had many friends who were part of MLMs, read all kinds of books, talk to their customers like they are doctor like that. But if anything goes wrong they will say "sorry I not doctor, you better go see your doctor". Fish man.

So what, people only respect their doctor if he knows all this crap about nutrition and alternative medicine? But when push comes to shove ask you buy the expensive supplements you say errrr.....so expensive.

In Canada, the doctors also dunno about all this alternative stuff. I mean seriously, why you want to teach stuff that is not proven? You really want you doctors selling snake oil? But in Canada people respect the doctor for his/her conventional medical knowledge. Not alternative medical knowledge.

For that you can go see the naturopath. But again if anything goes wrong, they have no tertiary centre to send you to where they can resuscitate you with some compound diluted to a million parts (Homeopathy) or get you to drink your own urine (auto-urine therapy). They will ask you to go to the A&E and see the doctors you despise.

It takes two hands to clap. It takes a trusting patient and a faithful honest doctor to have a good health care system. There is none of either in Singapore.



I think you have been out of touch with what Spore has become. Medicine today is very commercialised & it's more about $$$ than helping the patient.

Supplements like CoQ10 are recommended by various doctor in the US, even my MD doctor in JB recommends it. I use Ubiquinol which I get from iHerb & not from an MLM company.

I see supplements as a food that helps the body & not a miracle cure. I have been taking supplements for years & when I make changes to the mix I do feel the effects. I've also taken medications like plavix & suffered side effects e.g. nose bleeds. I would rather take Nattokinase which is a safer & non-prescription supplement.

I don't know about others but what I want is a holistic doctor. A doctor who will give priority to non-invasive techniques of treating an illness. In my case I have avoided open heart surgery by using EECP, chelation, supplements, & a change in life style. What is important to me is that it has worked & is much cheaper. Don't forget that Sporeans do not have medical insurance like what is available in Canada.

If you look at the cost of treatment don't forget that surgical procedure can cause deaths. People have died because they are allergic to the dyes used when inserting stents. Death has also been caused when tears are made in the artery. Open hear surgery is more dangerous & more can go wrong.
 
Last edited:

nayr69sg

Super Moderator
Staff member
SuperMod
Alternative medicine, supplements and their associated literature began in the 1st world countries. It is firmly entrenched in their psyche. So much so that there is now state controlled certification for some of these in some of these first world countries.

Yes. But patients don't go around dissing the doctor not certified in alternative medicine for not knowing all that.

If you want alternative medicine then go to an alternative medicine specialist.

Oh in Singapore there is no such thing? Then go to USA lah.
 

chootchiew

Alfrescian (Inf)
Asset
Mucus in stool? Sign of bacterial infection? Where did you smoke that up?

Anyway here's a secret we doctors do. If you give a suggestion and want a particular course of action eg antibiotics or whatever.....as long as it won't harm you and is not illegal, we tend to just accede to your request. Give you what you want. Then you will get out of the consult room.

It doesn't mean you were right.

Most diarrheal conditions hardly ever require antibiotics. Even in salmonella positive stool tests not all patients require ciprofloxacin.

Excessive mucus in the stools may suggest colon polyps or cancers that secrete excessive mucus. Or ir may just be the colon naturally secreting more leukocytes to fight infections.

Singapore is land of antibiotics. Antibiotics for everything.

ATS my foot.

Case file closed . What u say ?
 

scroobal

Alfrescian
Loyal
http://www.ccnm.edu/sites/ccnm/files/Section_8_regulation_licensure_1516.pdf

In Singapore there is no licensing of quack stuff like nathuropathy but in Canada some provinces do. So the comment about Canadian people knowing their stuff is way off. It has nothing to do with nationality or boundaries. Idiots are everywhere. Only difference is that the western idiots want their quacks to be certified.

No it is not the same around the world.

People in Canada know what the western medical doctor is for.

Alternative medicine is not part of our services. For that you go to the naturopath.

In Singapore, people belittle each other. All those people who cannot stand CCS paper general for acting like he knows everything and is smarter and better than everyone. Singaporeans are no different to each other also lah.
 

chootchiew

Alfrescian (Inf)
Asset
Yeah lah Dr chootchiew you were correct lah.

No stool test but can confirm bacterial infection. Given abx case closed. Well done Dr chootchiew.

What do I know man?

There is no reason for me to direct this for what purpose ?
As I said the doctor could have done it before I asked.
When I asked him then why the antibiotics stop the mucus, he could not give a firm answer. Facael ocult test didn't show sign of bacteria was the answer given. Wtf.
 

nayr69sg

Super Moderator
Staff member
SuperMod
http://www.ccnm.edu/sites/ccnm/files/Section_8_regulation_licensure_1516.pdf

In Singapore there is no licensing of quack stuff like nathuropathy but in Canada some provinces do. So the comment about Canadian people knowing their stuff is way off. It has nothing to with nationality or boundaries. Idiots are everywhere. Only difference is that the western idiots want their quacks to be certified.

What I meant is that canadians dun go to their regular doctors and expect them to tell them quack stuff. They go to the certified quack to hear quack.

Singaporeans will go to regular dr and think the doctor damn ignorant and lousy not interested in learning more because he doesnt know quack.

Get it scroobal? That is the difference. This is also why I believe Singaporeans continue to vote PAP. They have no idea what is normal and what it not normal. All expecting crazy things.

You get you want. You get what you deserve
 

nayr69sg

Super Moderator
Staff member
SuperMod
There is no reason for me to direct this for what purpose ?
As I said the doctor could have done it before I asked.
When I asked him then why the antibiotics stop the mucus, he could not give a firm answer. Facael ocult test didn't show sign of bacteria was the answer given. Wtf.

Exactly. Give abx or not no difference. Just that it is easier to give you what you want than to explain why not to give especially when you were so convinced giving abx was the right thing to do.

Aiyah singaporeans won't understand lah. Told you already it is a trick we doctors do to please patients and get them out of room faster.
 

chootchiew

Alfrescian (Inf)
Asset
Yeah lah Dr chootchiew you were correct lah.

No stool test but can confirm bacterial infection. Given abx case closed. Well done Dr chootchiew.

What do I know man?

I asked for the antibiotics before the ocult test result came. Of course I close the file myself since the antiobiotics did the job. having meet such doctor .
The big question I want to ask is.. why the doctor agree to me to prescribing the antibiotics when I asked for it ?
 

scroobal

Alfrescian
Loyal
None of what you stated are evidence based. There is no science behind it despite decades of selling this stuff. You probably live longer then most because you are strong willed and highly disciplined where your diet is concerned. If you remove all the supplements that you take and stop going to alternative practitioners, you probably remain very healthy as your diet and discipline is central and key. .

As to the rising cost of conventional medicine and the lack of medical safety net, I am with you where this Govt is concerned. We had so much surplus that it should have been invested into medical insurance for citizens.

I think you have been out of touch with what Spore has become. Medicine today is very commercialised & it's more about $$$ than helping the patient.

Supplements like CoQ10 are recommended by various doctor in the US, even my MD doctor in JB recommends it. I use Ubiquinol which I get from iHerb & not from an MLM company.

I see supplements as a food that helps the body & not a miracle cure. I have been taking supplements for years & when I make changes to the mix I do feel the effects. I've also taken medications like plavix & suffered side effects e.g. nose bleeds. I would rather take Nattokinase which is a safer & non-prescription supplement.

I don't know about others but what I want is a holistic doctor. A doctor who will give priority to non-invasive techniques of treating an illness. In my case I have avoided open heart surgery by using EECP, chelation, supplements, & a change in life style. What is important to me is that it has worked & is much cheaper. Don't forget that Sporeans do not have medical insurance like what is available in Canada.

If you look at the cost of treatment don't forget that surgical procedure can cause deaths. People have died because they are allergic to the dyes used when inserting stents. Death has also been caused when tears are made in the artery. Open hear surgery is more dangerous & more can go wrong.
 
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