global said:
Starting to get a little defensive and nervous sounding here aren't we "Doctor"?
Could it be that you realise your credibility is disappearing on this board?
You assume that I'm even seeking credibility on an internet forum. Your ignorance bleeds through the wounds that you too easily deliver upon your very own argument.
global said:
I'm very happy you have "talked" to a "lot of people" about the NHS in the UK. However as someone who both uses and works in the NHS I think mI feel a little more qualified to talk about it than you.
Your claim that I was treated quickly because a "lump in the tendon" is an easy diagnosis to make and so I got attended to quicker than someone with a more serious illness is of course quite ridiculous and just shows that you have neither any real medical knowledge or understanding of the British health system. How do you know the lump in my tendon wasn't a soft tissue tumor? How is that an easy diagnosis Doctor?
Of course as you "have talked" to "people" about the NHS you know that everyone has the right to be seen by a GP the same day if they ring on that day when surgery opens don't you? If not maybe you better go back to your "friends" and ask what to say next.
I suppose you also know that if you go to Casualty (ER for you) all patients must be seen within 4 hours, serious cases are seen first of course. No didn'tknow that? Oh what a surprise.
So, you've working in the British medical system? For how long and in which speciality? Because, like I said, I know quite a few doctors that have worked in that system for months and even years and they do not describe it the way that you do at all. In fact, you describe from the point of view of an outsider. Medically ignorant and professionally inept.
You are aware that many of the patients that end up going to the E.R. are those patients that were too complex for the physicians to see as triage typically ends up promoting the health of and granting admittance to only the easiest of cases.
And, yes, a lump is a very easy diagnosis. Is it moveable? If yes, then it's probably benign. Is it not moveable and firm? If yes, then get a biopsy. That's pretty easy. You'd know how difficult medicine is if you have ever worked with patients in diabetic ketoacidosis or with autoimmune diseases. You obviously lack the medical knowledge to even diagnose yourself, so I don't know why you keep calling me out. You're the one that looks ridiculous when you think you know it all, but YOU need a medical professional to tell you what is wrong.
global said:
Now once again I have to deal with your ridiculous and unscientific claims about side effects of steroids. I never said that sterids don't have side effects however I do dispute your idea that all steroid use is necessarily harmful which has absolutely no scientific basis.
As you well know (actually no you probably don't because you aren't a doctor or even anyone with basic knowledge of medicine) short term rises in BP or triglycerides have never been shown to be risk factors for CAD in active men.
I never said that all steroid use is harmful. Again, you're taking my words out of context. I said that ALL steroids have side effects. This a true statement.
As for short term rises in BP or triglycerides, are you aware that short term spikes in BP are associated with hemorrhagic strokes, aneurysms at numerous levels, kidney disease and death, and a host of other medical conditions?
Plus, you can't use a blanket statement like you used above. The medical profession doesn't know the outcome of such processes, because it has never been studied in a large enough population with an experimental arm using steroids and a control arm not using any steroids at all.
You're simply making assumptions. How unscientific of you. I should be the one questioning your credentials, because you don't seem to understand even the basic knowledge required to form a scientific opinion.
global said:
Regarding your comment about the liver again you demonstrate your ignorance because not all steroids affect the the liver. In fact oxandrolone for example has been shown to help regenerate the liver in alcoholic men. Again I don't claim that some steroids can't harm the liver with long term use but you are just repeating what you read somewhere without any real knowledge of the facts and I have to challenge that.
As to your claim that steroid users are like junkies then perhaps you can tell us all how patterns of steroid use fit with ICD 10 or DSM IV diagnostic criteria of dependence?
Now why don't you stop pretending to be a medical professional Doctor and leave these discussions to people who actually know something about medicine.
Yes, all hormonal steroids are metabolized by the liver and all are hepatotoxic at a particular dose. They have to be metabolized by the liver, so that they can be removed from the body. The underlying cause of the hepatoxicity can be prevented by steroid supplementation with particular agents, but that's not what we're discussing here.
And this...
"but you are just repeating what you read somewhere without any real knowledge of the facts and I have to challenge that."
...Is just the dumbest possible thing that you could have possibly written. Of course my knowledge is going to come from something that I read (ie a medical physiology and pharmacology textbook). Is that not one of the means by which a person can gather knowledge...reading! Wait, you're right. We should burn all the books, so that people can't read anymore. You sure do have the best ideas!
If you're going to say that, then I guess that everything you've ever read is also null and void. So, that leaves word of mouth and experience. I have both of those, because I have medical school class time and clinical experience. Do you have either of those? Probably not.
Finally, you said the following:
"perhaps you can tell us all how patterns of steroid use fit with ICD 10 or DSM IV diagnostic criteria of dependence?"
Now, you not only sound ridiculous, but you've also failed to read this thread. It has already been established that steroids are not addictive and hold no chance of chemical dependence. This was argued before congress before steroids were made Schedule III. However, steroids were tagged as such to create fairness among athletes and to prevent their sale on the black market and among teenagers. How can you not understand this fact? Do you not read or do you simply struggle with words that aren't monosyllabic?
