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Mister Fixit

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On 3/15/2021 at 2:17 PM, Lacessit said:

Every day? I'm jealous, once or twice a week is my usual.

Could not agree more, good healthy exercise.

"Golf and sex are about the only things you can enjoy without being good at it". ( Jimmy Demaret)

Golf???? Cannot think of anything so boring, but unlike darts and snooker, golf is good for you, all that walking is good exercise.

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I'm not saying there is not a legitimate use for TRT or sildenafil for sexual dysfunction but too many turn to prescriptions before even addressing poor lifestyle choices related to nutrition and exercise.

 

Too many doctors would rather take the easy way out by reaching for their Rx pad instead of counseling their patients on adopting healthier lifestyles.

 

“Let food be thy medicine, and let medicine be thy food.”  This famous quote, often attributed to Hippocrates, is a good adage to live by IMHO.

 

My rant for the day ????

 

Edited by WaveHunter
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On 4/12/2021 at 9:20 AM, polpott said:

The opinion I voiced came from one of the UK's foremost prostate cancer specialists. No need for Sheryl.

 

I remember my useless idiot of a UK GP refusing to prescribe testosterone injections for me in 2004.  He suggested that I read the biography of FloJo Joyner, the runner who he told me died of cancer due to using hormonal drugs to enhance her performance.  I later discovered she did no such thing - she died in her sleep after a massive epileptic seizure - why would he lie to me?

 

He said I'd get prostate cancer and die within two years if I had the shots.  Utter rubbish - I have shots every 3 weeks and here I am 17 years later in hale and hearty health aged 72, went on keto 4 years ago, lost around 50 kgs (110 lbs) over a few years and have kept it off.   Blood pressure is around 110-115 over 70/75 and my bloods were excellent a month ago.  

 

In fact, I shocked my practice nurse in the UK when I went back for a few weeks for my mother's 99th birthday in 2017.  I'd been on keto for 2 months, had lost 12 kgs and my blood pressure was down from 145/95 to 100/60!  She changed the batteries in her machine - same.  She did it the old fashioned way with a sphygmomanometer - same.  She was astonished and so was I.

 

I wonder whether  your 'UK foremost prostate cancer specialist' would agree with my GP?  In my experience, much UK medicine is extremely conservative at GP level, and not just my local idiot.  

 

 

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On 4/12/2021 at 12:26 PM, WaveHunter said:

I'm not saying there is not a legitimate use for TRT or sildenafil for sexual dysfunction but too many turn to prescriptions before even addressing poor lifestyle choices related to nutrition and exercise.

 

Too many doctors would rather take the easy way out by reaching for their Rx pad instead of counseling their patients on adopting healthier lifestyles.

 

“Let food be thy medicine, and let medicine be thy food.”  This famous quote, often attributed to Hippocrates, is a good adage to live by IMHO.

 

My rant for the day ????

 

 

In my case, as I pointed out upthread, my need for TRT is because I had a pituitary adenoma and not for sexual enhancement although I am sure it helped.  ????

 

And in my post above, you'll see I said that I lost 50 kgs body weight over a couple of years and have kept it off.  I have a pretty healthy lifestyle but my exercising has been cramped by 1) having 2 arthritic knees so can't run or even walk too far any more and 2) since Covid my local gym (part of the heart hospital) closed for a long time and now has a tedious system of booking which makes it very dificult to get a slot.

 

However, I am sure there are those who go for TRT just to be able to perform better and for longer.  I just want to be able to perform consistently!  ????

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On 4/15/2021 at 1:11 PM, Mister Fixit said:

 

In my case, as I pointed out upthread, my need for TRT is because I had a pituitary adenoma and not for sexual enhancement although I am sure it helped.  ????

 

And in my post above, you'll see I said that I lost 50 kgs body weight over a couple of years and have kept it off.  I have a pretty healthy lifestyle but my exercising has been cramped by 1) having 2 arthritic knees so can't run or even walk too far any more and 2) since Covid my local gym (part of the heart hospital) closed for a long time and now has a tedious system of booking which makes it very dificult to get a slot.

 

However, I am sure there are those who go for TRT just to be able to perform better and for longer.  I just want to be able to perform consistently!  ????

I certainly was not criticizing you or anyone else who has a legitimate medical need for TRT.  I was only making a point that many people unrealistically see it as a magic "fountain of youth" or an easy fix for a poor lifestyle.  Even for those with such unrealistic expectations, it's not solely their fault since the big pharma companies and many doctors make a lot of money off promoting such unrealistic expectations. 

Edited by WaveHunter
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5 hours ago, WaveHunter said:

I certainly was not criticizing you or anyone else who has a legitimate medical need for TRT.  I was only making a point that many people unrealistically see it as a magic "fountain of youth" or an easy fix for a poor lifestyle.  Even for those with such unrealistic expectations, it's not solely their fault since the big pharma companies and many doctors make a lot of money off promoting such unrealistic expectations. 

 

Sorry, I think I misconstrued your post.  Apologies.

 

BTW, you mentioned a male hormone blood test panel in a post way back.  Could you refresh my memory?

 

I am going to the Army hospital on Monday for a knee checkup and intend to ask the prof to refer me to the endocrinology department for these tests.

 

Can you refresh my memory as to what I should be asking for?  

I think it was both free and total testosterone,  oestrogen, oestradiol, LH, FSH and something else.  Can't remember what they all were now though.

 

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On 4/16/2021 at 8:47 PM, Mister Fixit said:

 

Sorry, I think I misconstrued your post.  Apologies.

 

BTW, you mentioned a male hormone blood test panel in a post way back.  Could you refresh my memory?

 

I am going to the Army hospital on Monday for a knee checkup and intend to ask the prof to refer me to the endocrinology department for these tests.

 

Can you refresh my memory as to what I should be asking for?  

I think it was both free and total testosterone,  oestrogen, oestradiol, LH, FSH and something else.  Can't remember what they all were now though.

 

A good doctor, well versed in TRT that you feel comfortable with and that you can truly trust is best to guide you on such things.  What I say here is only my personal opinion based on my own experience.

 

First, if you are not yet on TRT then the only test you really need to determine whether TRT might be appropriate is Total Testosterone (TT), assuming you are in otherwise good health. 

 

You could also have Free Testosterone (FT) tested, but a) it is a very expensive blood test, and b) the vast majority of people who test low for FT will also test low for TT, so there's no sense testing for FT right off the bat considering the high cost, and that if you do have low testosterone, the TT test will most likely diagnosis it.  Most doctors would only suggest an FT test after seeing the results of the TT tests.

 

The other tests you mentioned are mostly for monitoring and managing your TRT once you start treatment. They have very little to do with diagnosing low testosterone (hypogonadism).

 

Just to be clear, the tests that you would take periodically while on TRT include the other panels you mentioned like Estradiol, or Hematocrit, the reason being that TRT can have a noticeably undesirable effect on these values so monitoring them is quite important.

 

Just for illustrative purposes, these are the tests I have done every 6 months.  Some are not diredtly related to TRT, and are only for monitoring  general health / metabolic health:

 

1.   Total Testosterone  500 baht  (Specifically for TRT)

2.   Estradiol (E2)  400 baht (Specifically for TRT)

3.   CBC (includes hematocrit) 100 baht (Specifically for TRT)

4.   Blood sugar (FBS)  60 baht

5.   HbA1c (blood sugar) 300 baht

6.   CREATININE (kidney) 80 baht

7.    BUN (kidneys)  80 baht

8.    Lipid Profiles (Cholesterol, HDL, LDL Triglyceride) 360 baht

9.    Liver Function Test (LFT) 400 baht

10.  PSA (prostate screening)  500 baht (proscar can effect PSA) (Specifically for TRT)

12.  Cortisol 600

13.  AST 60THB (normal range: Males: 10 to 40 units/L

TTL Cost: THB 2760 = $88.38

Edited by WaveHunter
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On 3/20/2021 at 9:53 AM, Mister Fixit said:

I thought I'd update my avid readers with the latest news.

For various reasons, we didn't have a bonk last Wednesday night but last night the wife's niece went back the family home, so we could have a bit of privacy.

The wife came back from work 2 hours early so by 7.30 we were in the shower  and just after 8 pm, had an early night and very successful it was too.

I think that was helped by the fact that (unusually) we hadn't had a bonk for 9 days (usually it's about 5 or 6 days, maybe a week) so I was raring to go and I think the wife was too, hence her coming home early.

I used a Kamagra gel and then decided to make absolutely sure by taking half a Kamagra tablet (I have a pill cutter).  Worked like a charm.

Next time I think I will try two of those Grakcu things as an experiment and then if they don't work, go back to trying just one Kamagra tablet or gel.

Also, I have a knee checkup on 19th April so when I am there I will ask the doc to refer me to an endocrinologist and/or urologist.  I go to the Army hospital who are pretty good, so I will ask for a full hormone workup as has been suggested.

Many thanks for reading my little saga!  ????  If there are any further issues, I shall put them here.

 

Errr.. Do you write that much every time you have sex? It would give me a sore wrist, most definitely.

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3 hours ago, Sticky Rice Balls said:

Ahh how I recall the good ole days I could get one of these on loy kroh from isaan granny for 300 bt ????

A lot better than most western countries where the typical cost of a PSA test is around 2,000 baht (USD 60).  In fact, when I started TRT and lived in the US, my 6 month battery of blood panels cost around $1,300 USD (billed to insurance company).  Kind of shocking for someone without insurance, how medical costs are astronomical in the US since it is based on insurance companies covering the cost...AKA a ripoff by the labs!

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14 hours ago, Boomer6969 said:

Errr.. Do you write that much every time you have sex? It would give me a sore wrist, most definitely.

 

You have sex your way and I'll have sex mine.  At least I'm not alone ...  ????

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On 4/18/2021 at 9:17 PM, WaveHunter said:

A good doctor, well versed in TRT that you feel comfortable with and that you can truly trust is best to guide you on such things.  What I say here is only my personal opinion based on my own experience.

 

First, if you are not yet on TRT then the only test you really need to determine whether TRT might be appropriate is Total Testosterone (TT), assuming you are in otherwise good health. 

 

You could also have Free Testosterone (FT) tested, but a) it is a very expensive blood test, and b) the vast majority of people who test low for FT will also test low for TT, so there's no sense testing for FT right off the bat considering the high cost, and that if you do have low testosterone, the TT test will most likely diagnosis it.  Most doctors would only suggest an FT test after seeing the results of the TT tests.

 

The other tests you mentioned are mostly for monitoring and managing your TRT once you start treatment. They have very little to do with diagnosing low testosterone (hypogonadism).

 

Just to be clear, the tests that you would take periodically while on TRT include the other panels you mentioned like Estradiol, or Hematocrit, the reason being that TRT can have a noticeably undesirable effect on these values so monitoring them is quite important.

 

Just for illustrative purposes, these are the tests I have done every 6 months.  Some are not diredtly related to TRT, and are only for monitoring  general health / metabolic health:

 

1.   Total Testosterone  500 baht  (Specifically for TRT)

2.   Estradiol (E2)  400 baht (Specifically for TRT)

3.   CBC (includes hematocrit) 100 baht (Specifically for TRT)

4.   Blood sugar (FBS)  60 baht

5.   HbA1c (blood sugar) 300 baht

6.   CREATININE (kidney) 80 baht

7.    BUN (kidneys)  80 baht

8.    Lipid Profiles (Cholesterol, HDL, LDL Triglyceride) 360 baht

9.    Liver Function Test (LFT) 400 baht

10.  PSA (prostate screening)  500 baht (proscar can effect PSA) (Specifically for TRT)

12.  Cortisol 600

13.  AST 60THB (normal range: Males: 10 to 40 units/L

TTL Cost: THB 2760 = $88.38

Thanks for all that - it's a bit late here and I was up at 5.30 am to go for my knee check up so I will answer tomorrow or Wednesday.
Good price guidelines too.
I have most of those done, apart from hormones, at the National Chest Institute at Khae Rai Nonthaburi, 5 minutes from home.
I'll scan the latest results from March 5th (and the cheap bills) when I get a chance and post them here.

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21 hours ago, WaveHunter said:

A lot better than most western countries where the typical cost of a PSA test is around 2,000 baht (USD 60).  In fact, when I started TRT and lived in the US, my 6 month battery of blood panels cost around $1,300 USD (billed to insurance company).  Kind of shocking for someone without insurance, how medical costs are astronomical in the US since it is based on insurance companies covering the cost...AKA a ripoff by the labs!

Agreed Ive been lucky as I live near Johns Hopkins and every year they do a free screening which includes the blood PSA and the "finger" check.. even better as after the blood we wait for the digit test..a hallway with 2 rooms..one male doc and one female..Ive been lucky to score the female, who was very cute too! ????

 

I went in last week for the camera down my "member"..was doing good when the nurse came in to numb me up and clamp me with some gel.....was all smile until the doc came in and shoved that camera tube device into me and i was face to face with my bladder and prostate on the jumbo tron...my nemesis if you will....no fun

 

Is the main reason I live in LOS..cheap living compared to the states....only come home to work and fill up the piggy bank and Im back to LOS to be hansum again!

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11 hours ago, Mister Fixit said:

Thanks for all that - it's a bit late here and I was up at 5.30 am to go for my knee check up so I will answer tomorrow or Wednesday.
Good price guidelines too.
I have most of those done, apart from hormones, at the National Chest Institute at Khae Rai Nonthaburi, 5 minutes from home.
I'll scan the latest results from March 5th (and the cheap bills) when I get a chance and post them here.

Hope the niece is well...maybe entice her with a new thai phone app to keep her distracted  ????

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2 hours ago, Sticky Rice Balls said:

Agreed Ive been lucky as I live near Johns Hopkins and every year they do a free screening which includes the blood PSA and the "finger" check.. even better as after the blood we wait for the digit test..a hallway with 2 rooms..one male doc and one female..Ive been lucky to score the female, who was very cute too! ????

 

I went in last week for the camera down my "member"..was doing good when the nurse came in to numb me up and clamp me with some gel.....was all smile until the doc came in and shoved that camera tube device into me and i was face to face with my bladder and prostate on the jumbo tron...my nemesis if you will....no fun

 

Is the main reason I live in LOS..cheap living compared to the states....only come home to work and fill up the piggy bank and Im back to LOS to be hansum again!

Was it painful during/afterwards?

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13 hours ago, Mister Fixit said:

Thanks for all that - it's a bit late here and I was up at 5.30 am to go for my knee check up so I will answer tomorrow or Wednesday.
Good price guidelines too.
I have most of those done, apart from hormones, at the National Chest Institute at Khae Rai Nonthaburi, 5 minutes from home.
I'll scan the latest results from March 5th (and the cheap bills) when I get a chance and post them here.

Always helpful when people post their lab test results and provide pricing info; just don't forget to blank out personal info if you scan the test results. 

 

BTW, did you say it was a (thai) military hospital you are going to?  I had to go to one once for a physical so I could participate in a Thai martial arts competition.  All the soldiers on the hospital grounds carrying automatic weapons, and one in particular who stood right next to me, seemingly very interested in watching me get my blood pressure tested got me so nervous I had to take the test several times in order to pass.  Something about those automatic rifles they carry is very intimidating LOL! ????

 

Edited by WaveHunter
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@WaveHunter

The hospital in question is Phramongkutklao hospital 500 metres from Victory Monument.  It's the main Bangkok army hospital,  perhaps for the country, I don't  know.

 

Not a weapon in sight.  Just excellent doctors and helpful staff.

 

AND I only paid 50 baht to see the top hip and knee replacement surgeon in Thailand - president ot the Thai hip and knee replacement association.  

 

TV1.jpg

TV2.jpg

Edited by Mister Fixit
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@WaveHunter

 

These are my blood test results from the National Chest Institute in Nonthaburi, 500 metres from home, taken 5 March so quite recent.

 

Forget the cholesterol figures.  I know they are high but they've barely changed in 10 years and as my mother had high cholesterol for the last 40 years of her 101-year long life, my doc isn't too concerned.  Obviously we will monitor 6-monthly, but we both think it's due to familial hypercholesterolemia.  

 

I do take 20 mgs atorvastatin daily, just as a precautionary measure, but I am considering not taking it until my next appointment in August and see what the outcome is.  

 

Lovely lady doctor who keeps applauding my keto weight loss of 50 kgs overall, so she's not one of those who thinks it's a killer eating regime.

 

The entire cost was 1,005 baht for an ECG and full chest X-ray and 590 baht for that blood work.  Cheap as chips.  

Suan ok 2.jpg

Suan ok 1.jpg

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8 hours ago, Sticky Rice Balls said:

Hope the niece is well...maybe entice her with a new thai phone app to keep her distracted  ????

 

Whoopee, she's had to work from home after Songkhran!  I can walk about b*ll*ck naked all day again!  ????

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1 hour ago, Mister Fixit said:

@WaveHunter

 

These are my blood test results from the National Chest Institute in Nonthaburi, 500 metres from home, taken 5 March so quite recent.

 

Forget the cholesterol figures.  I know they are high but they've barely changed in 10 years and as my mother had high cholesterol for the last 40 years of her 101-year long life, my doc isn't too concerned.  Obviously we will monitor 6-monthly, but we both think it's due to familial hypercholesterolemia.  

 

I do take 20 mgs atorvastatin daily, just as a precautionary measure, but I am considering not taking it until my next appointment in August and see what the outcome is.  

 

Lovely lady doctor who keeps applauding my keto weight loss of 50 kgs overall, so she's not one of those who thinks it's a killer eating regime.

 

The entire cost was 1,005 baht for an ECG and full chest X-ray and 590 baht for that blood work.  Cheap as chips. 

My eGFR value is about the same as yours and the hospital where I have my annual health check is always suggesting I see a nephrologist. According to the hospital, the normal range is >90. This is despite the fact that my readings have been constant for the past 7 or 8 years. I am 58 years old.  I also understand that the anything above 60 is normal. There just appears to be differing views on this. 

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That's very cool of you to share your blood panels and experience at the Hospital.  It's true that cost of lab work here in Thailand is an outright bargain (or perhaps the costs in Western countries is an outright ripoff).

 

As far as high cholesterol goes, I also have always had the same high results but my doctor assured me that high cholesterol was really nothing to be concerned about if you are otherwise in good health.

 

She is VERY well read on metabolic sciences (unlike many doctors) and her feeling is that high cholesterol, and even high LDL have been vastly over emphasized as danger markers to your health. 

 

She pointed out to me that cholesterol is actually vital to good health; that it serves a vital function (especially for the brain), and that a healthy body normally produces around 3,000 mg of cholesterol per day! 

 

Why would a healthy body do that if it was so dangerous to your health as we have been led to believe?  Even people who ate nothing but eggs or other high cholesterol foods all the time would be challenged to consume that much cholesterol, so just how bad can these foods really be for you?

 

There are absolutely certain nutritional dangers to good health but apparently cholesterol is not one of them.

 

There's a real paradigm shift taking place in the last few years from research by smart and well-informed medical professionals who are starting to think "outside the box" about metabolic health.  A lot of these old myths about cholesterol, high fat diets, etc are starting to be debunked.  From what I've read, the real culprit to good health is excessive carbohydrates, especially highly processed ones like you find on supermarket shelves.

 

I'm an enthusiastic follower of one such doctor who posts regularly to YouTube.  He's only a country doctor, a GP from South Carolina, but he speaks nutritional wisdom that is ENTIRELY science-based.  I suggest that anyone interested in maintaining good health check out his channel.  He's GREAT!

 

https://www.youtube.com/user/KenDBerry

 

 Just food for thought ????

 

Edited by WaveHunter
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11 minutes ago, WaveHunter said:

That's very cool of you to share your blood panels and experience at the Hospital.  It's true that cost of lab work here in Thailand is an outright bargain (or perhaps the costs in Western countries is an outright ripoff).

 

As far as high cholesterol goes, I also have always had the same high results but my doctor assured me that high cholesterol was really nothing to be concerned about if you are otherwise in good health.

 

She is VERY well read on metabolic sciences (unlike many doctors) and her feeling is that high cholesterol, and even high LDL have been vastly over emphasized as danger markers to your health. 

 

She pointed out to me that cholesterol is actually vital to good health; that it serves a vital function (especially for the brain), and that a healthy body normally produces around 3,000 mg of cholesterol per day! 

 

Why would a healthy body do that if it was so dangerous to your health as we have been led to believe?  Even people who ate nothing but eggs or other high cholesterol foods all the time would be challenged to consume that much cholesterol, so just how bad can these foods really be for you?

 

There are absolutely certain nutritional dangers to good health but apparently cholesterol is not one of them.

 

There's a real paradigm shift taking place in the last few years from research by smart and well-informed medical professionals who are starting to think "outside the box" about metabolic health.  A lot of these old myths about cholesterol, high fat diets, etc are starting to be debunked.  From what I've read, the real culprit to good health is excessive carbohydrates, especially highly processed ones like you find on supermarket shelves.

 

I'm an enthusiastic follower of one such doctor who posts regularly to YouTube.  He's only a country doctor, a GP from South Carolina, but he speaks nutritional wisdom that is ENTIRELY science-based.  I suggest that anyone interested in maintaining good health check out his channel.  He's GREAT!

 

https://www.youtube.com/user/KenDBerry

 

 Just food for thought ????

 

 

 

 

Anyone who quotes dietary cholesterol when trying to defend high blood cholesterol has little credibility in my eyes.

 

 

I would be changing my doctor if she contradicted these facts:-

 

High blood cholesterol levels are a risk factor for heart disease. However, dietary cholesterol has little to no effect on blood cholesterol levels in most people. More importantly, there is no significant link between the cholesterol you eat and your risk of heart disease

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7 hours ago, WaveHunter said:

My overriding point is simply that everyone should be focused on science based explanations, not simply accepting outdated and scientifically unfounded dogma (i.e.: things laid down by an authority as incontrovertibly true when actual science does not support them).

 

Hit the nail smack on the head there.  There's so much 1970's bullsh!t still going around 50 years later and it's just accepted as fact and never questioned.

I did watch a few Ken Berry videos when I started out on keto and I was convinced.  

 

I started a ketogenic way of eating almost 4 years ago (May 8 2017) and overall lost around 50 kgs or 110 pounds and have kept it off by strictly limiting carbs to 20 grams per day or less.
Oh, and I usually eat 2 hard boiled duck eggs with breakfast almost every day.
 

Never been healthier - my cardiologist said just last month 'you just radiate healthiness, especially for a 72 year old'.  Very nice of her. She was sceptical about keto when I first started seeing her about 3 years ago but she's convinced now all right.

So did the lady doc at my local clinic after I'd been on keto for about 4 months and so did my UK practice nurse when I went for my free blood tests when I did my annual trip back.  May as well have them when I'm there as they are free.  


The UK nurse was stunned when I showed her my blood pressure readings from February 2017 of 145/95.  After 2 months keto they were 100/60.  She was so shocked that she changed the batteries in her machine and then did it again manually.  Same every time.

 

Finally, I have a friend who is a professor of child psychiatry.  When I last met him in 2018 and mentioned my cholesterol was high, he just said 'Don't worry, cholesterol measurement is a highly imprecise science'.    'Nuff said.

 

EDIT -  Monday last (19th) I went to have a knee checkup at Phramongkutklao hospital (main army hospital) and saw the Big Prof, president of the Thai hip and knee replacement association.
He said 'your knees have almost completely had it and you need a double replacement, but your general health is excellent'.   He asked me how and I told him 'you told me to lose 20 kgs about 8 years ago, so I lost 50 kgs instead'.  

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