• Health conditions that run in your family (examples: breast or other cancers, diabetes, high blood pressure, alcoholism).
  
• Past illnesses and what medical treatment you had for each.
  
• Past hospitalizations and any surgery you have had.
  
• Medications you take, have taken (names, doses, side effects, if any).
  
• Number of pregnancies, their outcomes and any problems you had.
  
• Birth control method(s) you have used and use now and side effects, if any.
  
• Menstrual history, when you started your periods, if they’ve been regular or not and if you have or have had any problems.
  
• Take the list with you when you go to the doctor’s office.

Second:

• Diagnosis (What’s wrong?)
  
• Why do I have this problem? Ask the doctor to explain any medical terms you don’t know.
  
• Do I need more testing? If so, what? How much do these tests cost? Will my insurance cover them? Where do I get the information?
  
• Prognosis (What will happen?)
  
• How will this problem affect me in the future?
  
• Treatment (What should I do?)
  
• What treatment should I follow? This could include medical treatment or changes to diet or lifestyle.
  
• What will happen if I don’t treat it now?
  
• How do I get ready for any tests that I need?
  
• How often should I have a mammogram, pelvic exam, pap smear and professional breast exam? Should I have any tests for STDs?
  
• What other tests should I have and when?
  
• Do I call to schedule the test or does your office do it for me?
  
• When and how will I get the test results?
  
• Should I call you?
  
• When do you want to see me again?
  
• What else should I know?
  
• Can I get any more information about this problem?
  
• Are there any local or national health organizations that I can call or write to for more information? Do you have their numbers and addresses?
  
• Where should I go if I need emergency care?
  
• Specialists (What about seeing another doctor?)
  
• Should I see a specialist?
  
• Does this specialist work out of more than one office?
  
• Whom should I see? Can you write this down for me?
  
• Is this person board certified?
  
• How soon should I be seen by this specialist?
  
• What if I can’t get an appointment for a month or more? Can you help me get in sooner or should I try to see someone else?
  
• Doctor Fees (How much will this cost me?)
  
• What will this office visit cost me today?
  
• What will the fees be for other services? Ask this before you get the services.
  
• What does my health insurance cover?
  
• Medications (What will the medicine do?)
  
• Why do I need this medicine?
  
• What is the name of the drug?
  
• How and when should I take it?
  
• Are there any foods, drinks or things I should avoid when taking this medicine?
  
• What should I do if I forget to take it?
  
• Should I expect side effects?
  
• Is this drug known to cause birth defects? (For women who are pregnant or planning a future pregnancy.)
  
• Will I have to take this medicine for a short time or from now on?
  
• Is there a generic equivalent of this medicine?
  
• Will this medicine be okay to take with other medicine I’m already taking?
  
• Could any non-drug measures work as well?
  
• Surgery (What if I need an operation?)
  
• Do I need surgery at this time?
  
• Who will do the surgery? How many times has this surgeon done it?
  
• Is there a certain time of the month I should have this surgery?
  
• What are my choices with surgery? Ask about minor procedures vs.. major ones.
  
• Do I have any choices instead of surgery?
  
• What are the benefits? What are the risks?
  
• Where will I have this surgery?
  
• Can I have the surgery as an outpatient?
  
• Where can I get a second opinion? Know if your insurance company needs a second opinion for surgery. Find out what their rules are. Your insurance company may want you to call a certain number and use certain doctors for second opinions.

https://healthy.net/2000/12/06/thallium-2/?utm_source=rss&utm_medium=rss&utm_campaign=thallium-2 Wed, 06 Dec 2000 13:28:02 +0000 https://healthy.net/2000/12/06/thallium-2/
Thallium has again become a toxicity concern. Discovered in the 1800s by Sir William Crookes, it was used in medical treatments, for venereal diseases, gout, and tuberculosis. Its toxicity, however, caused it to fall into disuse, though thallium acetate continued to be employed for fungal skin infections for some time.

Industrial use of thallium has increased in recent years. It can form useful alloys with silver or lead and may be a byproduct of zinc and lead production. In electronics, thallium is used in power systems, such as batteries or semiconductors. It is also employed in optical lenses, photo film, jewelry, dyes and pigments, and fireworks. A bigger concern was its uses in pesticides and rodentocides, which were banned in 1975. Thallium sulfate was used with starch and glycerin to treat grains for poisoning squirrels and rodents. This led to some fatalities when humans mistakenly consumed some of that grain.

Thallium is in low concentration in the earth’s crust. Humans cannot tolerate much thallium in their bodies. This mineral and its salts can enter our body through our skin, respiratory tract, or gastrointestinal route. It can be toxic in several ways. First, it can substitute for potassium in certain functions within the red blood cells, such as in the sodium/potassium ATPase. Thallium also has a strong attraction to sulfhydryl groups and thus may interact with these active enzyme sites. Thallium can pass the placenta into the fetus. There is some suggestion that thallium has teratogenic effects.

Thallium has significant toxicity effects both with large acute exposure and lower-level, chronic intake. Acute ingestion can lead to nausea, vomiting, abdominal pain, bloody diarrhea, fatigue, and fever. This can be fatal through its secondary agitation state which can cause seizures and then coma and respiratory failure. If people survive this exposure, further problems can affect the kidneys, heart, and nervous system. Sensory and motor changes, peripheral neuropathy, loss of reflexes, hair loss, arrhythmias, and renal disease may result. This may progress over several weeks. Most ingested thallium goes to and is excreted by the kidneys; the remainder is stored in many other tissues.

Chronic poisoning may cause polyneuritis with an inability to walk, fatigue, weight loss, and possibly reduced immunity. Thallium acetate has been used as a purposeful poison on several known occasions. Since it has no color or taste, it is well concealed in food and drinks; and it is not commonly looked for.

Thallium can be measured in the blood or urine. A 24-hour urine collection may reveal increased levels of this toxic mineral. A treatment with potassium chloride or EDTA may show increased levels of thallium in the urine.

Treatment for thallium poisoning is somewhat complex. Agents such as EDTA, dimercaprol, penicillamine, sodium iodide, and thiouracil have all been used with some benefit. Diuresis and potassium chloride are used more standardly to reduce thallium toxicity by increasing excretion levels. Prussian Blue (potassium ferric cyanoferrate) dye has been used to trap thallium in the gut after initial ingestion. Hemoperfusion or dialysis is used to reduce blood concentrations of thallium. Overall, we would be wise to avoid exposure to thallium.

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