Česky
Doctor, why did you choose to study medicine and what was the path to your later specialisations - endocrinology and diabetology?
The choice to become a doctor was certainly not clear from childhood, but rather a gradual one. I was already interested in biology in primary school, and then chemistry in high school. In the 3rd year of high school I was deciding between the Faculty of Science and studying medicine, and in the end medicine "won", even though we don't have any doctors in the family. Certainly I was influenced by the fact that my grandfather was very ill at this time and I did not know how to help him more.
I was already interested in the field of endocrinology at the faculty. It is a field that deals with the diagnosis and treatment of hormonal disorders of the endocrine glands. Some of these glands include the thyroid, parathyroid, adrenal glands, gonads, pituitary gland, and others. Hormones and their production interact with each other. It is necessary to know these relationships when making a diagnosis, and that is the beauty of this field, thinking about and being aware of the individual relationships. Only then can this lead to a correct diagnosis and successful treatment. And as far as diabetology is concerned, this field is now affiliated to endocrinology as part of the attestation, so that by passing the exam you become both an endocrinologist and a diabetologist. So for me it was more of a nice "bonus". Diabetology has seen amazing developments in treatment over the last 10 years or so. Thanks to this, we now have many new types of drugs available and can tailor treatment to the patient...
What can your outpatient clinic offer to the patients of Hořovice?
I am very happy that we can offer patients modern trends of therapy and care in diabelogy. Within our outpatient clinic we provide diagnosis, treatment, education and consular activities for different types of diabetes (type 1 diabetes mellitus, type 2 diabetes mellitus, gestational diabetes, secondary types of diabetes). Diabetes is a disease that "does not hurt" and is therefore all the more dangerous in its consequences. If left untreated, diabetes can lead to very serious complications (heart attacks, strokes, lower limb amputations, kidney failure, visual impairment and even blindness). If they occur, we have the opportunity to collaborate with doctors from other disciplines such as nephrologists, cardiologists, surgeons, ophthalmologists, ... I would also not like to forget GPs, whose role in early referral is very important.
As far as endocrinology is concerned. The largest part is made up of patients with thyroid disease, where, in addition to laboratory collections, in the outpatient clinic we perform sonographic examinations of the thyroid gland, and, if necessary, biopsies under sonographic control (i.e. removal of cells from the affected area of the thyroid gland, most often the so-called node).
Diabetes and thyroid problems are widespread. What are the reasons? Do people underestimate these problems?
You are absolutely right. Both of these diseases are very prevalent. There are now about 860 000 diabetics in the country and their number has doubled in the last 25 years. The cause is a general increase in the number of autoimmune diseases, an ageing population and, above all, an unhealthy lifestyle, and heredity is also partly involved. The most important thing is to explain to patients with diabetes the seriousness of the disease and the fact that in most cases it is incurable. Good cooperation between doctor and patient is always necessary. If there is inadequate treatment on the part of the doctor or, on the contrary, non-cooperation on the part of the patient ('bad' diet, lack of exercise), the outcome will never be ideal.
As far as the thyroid gland is concerned, in recent years, I would highlight in particular the cooperation with gynaecologists and obstetricians, who take not only blood sugar but often also thyroid hormones from women during pregnancy. The period of the first three months of pregnancy is the most important for the proper development of the brain and spinal cord in the foetus. Thus, early initiation of therapy can greatly influence the further development of the fetus.
Is thyroid function really that much linked to obesity?
This is a beautiful question and unfortunately has become a bit of a general myth. I will probably disappoint many patients, but the influence of the thyroid gland on obesity is quite minimal. Thyroid hormones in our body affect many systems such as the cardiovascular system (heart, blood vessels), metabolism and more. However, as far as weight is concerned, it manifests itself mainly in the case of excess hormones (so-called hyperthyroidism), in which, among other things, weight loss occurs (usually 5-10kg, sometimes more). In severe untreated hormone deficiency (called hypothyroidism), there may be a slight weight gain, mainly due to water retention, but usually up to 5kg.
As a diabetologist-endocrinologist, how do you assess the huge inclination of people towards various alternative treatments?
In my opinion, the shift of people away from conventional medicine is mainly due to the lack of time a doctor can devote to a patient. They then feel that the doctor does not pay enough attention to them and look for an alternative. When patients ask me for my opinion, I don't discourage them from alternative methods. However, I always try to stress that they should use these methods as a complement to the established therapy.
What are your hobbies? How do you relax?
At the moment, hiking is the biggest relaxation for me. Traveling combined with nature photography, especially mushrooms, which I also try to pursue a little deeper. From sports, cycling. I am also into philately and regional history, I like to watch a movie or read a nice book from time to time.
