Cardiologists and blood tests

[DavidR450]

Hi all,

I have recently moved to HK (3 weeks ago), and have hit a bit of a challenge!

9 years ago, I had a heart operation that requires me to take warfarin (coumadin) - an anticoagulant (more commonly known as blood thinners).

Now, the nature of anticoagulant therapy indicates that the patient (me) must have periodic blood tests (PI or INR - blood clotting time test) to regulate the medication dosage. These should be taken at intervals of anything from 1-2 wees, to 6 weeks apart!

Back home (in South Africa), my warfarin dosage was monitored and controlled by a local pathology lab. I would go to the lab, they would take my blood & phone me within 24 hours to tell me wither to change my dosage, or to keep the dosage the same, and when they needed to see me again. My warfarin was prescribed by my cardiologist, but he was simply informed about the blood test results and any changes in dosage.

I went to Quality Health in Tung Chung, and was told that the only way to get a blood test is to have a doctor's consultation ($220), then the test ($140), and then to get any shift in dosage, another doctor's consultation ($220). The doctor also told the receptionist that he was unable to provide dosage modifications, and that I would need to see a cardiologist! From something that, in South Africa, cost me the equivalent of HK$75 per month, this os going to gost me at least $600 per month, probably more!

does anyone have suggestions? I am a HKID holder (dependant visa), and don't mind going to the public health service, but what is the liklihood of be actually getting this done in a realistic time frame?

On the other hand, are there any competent pathology labs that can offer the service in HK that I was receiving in SA?

any input would be appreciated! I have only secured PT work at the moment, and have no local medical insurance, so the budget is very limited at the moment!

David

[shri]

Perhaps try and get in touch with the hospital authority to see if they can do this in a less painful manner. You will need a referral from a GP to get into the system and the wait could be 3-6 months.

Also might be worth shopping around to see if there is a GP outside of the medical networks like Quality Health who will modify the prescriptions for you.

I have a feeling that the labs themselves cannot modify prescriptions ... perhaps due to liability issues etc.

[Claire ex-ax]

Also see about a referral to Tung Wah Hospitals. I think the one(Eastern) in Causeway Bay covers cardiology.

[MovingIn07]

I cannot believe this is the only way. I know exactly how you feel - I had to take warfarin for a DVT a couple of years ago and the setup in Aus was exactly what you describe in South Africa. On a business trip to the UK, I went to see my (parents) local doctor and they did a blood test there and then and gave me the results.

Could you perhaps just try another clinic? You may have just come up against a receptionist who does not know the system? Or try getting a recommendation from your doctor in South Africa - they might be able to talk to a specialist here and give you the correct information?

Do you have private health insurance? Or any of those schemes that give you an international phone number to call and ask these types of questions? I know my scheme has one (it's a US one my work pays for) but I think also many travel insurances also have such numbers. They too might have some more helpful advice.

Sorry I cannot be more helpful - I don't need to take it anymore - but I do exactly understand the issue!

[shri]

>> Could you perhaps just try another clinic?

I suspect this might be the best option. Might even be worth it to drop the private hospitals a line (Canossa / Adventist etc).. they tend to have specialists available in the OPD who might be able to set you up on a schedule.

[wtbhotia]

private hospitals

Just those 2 words put together, the service will cost you an arm n a leg. Very pricey.

[Claire ex-ax]

If you feel comfort setting the dosage yourself, you can go to a private path lab and have the test done.

[DavidR450]

Thanks for the reply, everyone.

unfortunately, my medical insurance in South Africa, while excellent for local things, is limited to emergency inpatient and repatriation for major medical issues. There is no real cover for anything of value outside of the country. It is not an internationally-aware medical insurance!

I understand the liability issue, and I also (sort of) understand the reluctance to provide dosage modifications - either by the lab, or by the doctor - as I should ultimately be a cardio patient - but surely I should be able to decide...

theoretically, I know enough (having taken Warfarin for the past 9 years) to modify my own dosage...but I'd like the changes on some official record! (sigh).

So, can anyone refer me to another centre. I am living, at the moment, in Tung Fuk (South Lantau Island), but plan on living in Tung Chung within the next 3 months. I don't mind travelling to Causeway bay, or anywhere else - it is only once a month I need the test!

Also, I am a tad concerned that with the change in lifestyle (increased exercise from walking, increased heat exposure, different diet, etc), my metabolism has changed. I can't afford to wait for 3-6 months before getting the test. even if I can just get the test & self-medicate until I get a chance to speak to a doctor, it would give me immense peace of mind...

thanks again, in advance!

David

[shri]

Not always. I prefer to go to the OPD in Canossa. Usually costs $180 + meds to see the GP. Prefer that than the chain clinics or expat GPs in central who can run $400.

The fact that the OPD is open 24 hours (costs more after a certain time.. and on Sundays I think) is a big plus for me.

[DavidR450]

Hi Clare,

do you know where there is a private path lab that I can do this - even in the meantime. I am comfortable doing this, but when I speak to the path labs, they all ask for a referral letter.

Thanks