smiles793

Jeez.. it's taken me an hour to get back thru the new TV re-authentication system....

anyway diddling or not diddling....and there has been a lot of diddling on this forum over the years....a lot... lol

but it seems that , notwithstanding all the rhetoric , there are no business persons here (except Don) , or if there are , they don't want to give anything away....and who could blame them...

as I mentioned above.. I would be interested in meeting fellow farangs who ....

- enjoy and respect Thai culture (this would exclude 80% of farangs I've met)

- have a bachelors degree and relevant professional experience (this would exclude 95% of farangs I've met)

- have achieved something in their life.

Now, the weird thing is, 99% of the westerners I know outside of Thailand fit those categories, but the farangs in Thailand - 5% max, and in sunny CR even less.

As far as yr question abt accounts, well you are the local chiangrai expert at diddling the system, after all you've spent 8 years doing it. It's been a very long war of attrition hasn't it? You must be so proud of yourself ;-)

As far as Rotary Clubs are concerned, anyone can Google their business, it's transparent (kind of).

But to me it's always seemed so strange that their so charitable donations in Thailand are so small.

A slap up Sunday discount brunch at Meridien costs more than to keep a hill family in nosh for the month.

And you know that most of you Meridien guys are somewhat overweight.

It's so bizarre you western fatties are trying to keep up with the Joneses by seeing how much you can eat.!!! And trying these days to be politically correct at the same tim :-)

That's the most information-rich post you have made in 15 years.

My attitude to Rotary Clubs is similar to yours about the local Hash Harriers. Yukde.

Just to clarify,the people I am interested in meeting are 1. Experienced, ie long-term school-boys or trust fund babies don't cut it - I guess that removes 5 % 2. respectful of other cultures - I guess that removes 95%. 3. Educated to bachelor's level or above. I guess that removes 90%.

I guess y're smart enough to know those %s aren't exclusive.

Sorry Don, there seems to have been a ToT

network problem this evening.

Yes, I work with a work permit, and always have done, and I admire people like you who do the same.

I have also received awards from the Thai government for services to the community.

I would love to meet up with similar folk, ie those who respect and contribute to Thai society.

To the best of my knowledge there is no forum for such persons to meet (and yes, I am aware of the current range of expat clubs).

Hiboomer, are u the guy whose website says he copped out of high-school?

Rjb, I am replying to the op's op. He seems to have some business experience or knowledge, which is unusual for this forum. If you have such, please help us.

Wow rjb why so negative?

Don, I'm sure a man of yr experience will understand why I won't put my whole cv on a forum which is more oriented to helping decade long expats finding their way to burger bars rather than discussing economics.

I have been successful in business here so far, although I was really hoping to just relax and "chill" on the beach when I initially "retired" here.

It seems to me that there quite a few people on TV just "trading" on the fact that they have been here a long time; wow, so what,my maternal grandma has been here longer than any of them, as have the trees in my garden.

My success is based on 3 things: my experience and education; my Thai partners' experience and education; luck (and judgement).

Chiang Mai Ram now offers the prostate PHI test, which is made on a standard blood sample and can be an alternative to a biopsy in some cases: Dr Bannakit’s rule of thumb is for PSA under 10. The list price is 18,000 baht.

PHI is a comparatively new test, and Dr B says Ram is the only place in Thailand to offer it. Plenty of info on Google.

Reading Uni would not be a bad option. It's recently received a glowing report from Ofsted for its PGCE.

It's probably the closest uni to Heathrow, which could be an important consideration for international students and their families. It's close to central London (30-40 minues by train) but far enough away not be a suburb of that great metropolis, and close to some of the most beautiful upstream stretches of the River Thames.

Also close to some world-renowned heritage sites... Stonehenge, Windsor Castle, Stratford upon Avon (Shakespeare's old place), the 2,000 year old Roman City of Bath etc etc

Great rail links, having been an important Victorian Railway town. But with a modern feel as it's at the centre of the silicon IT corridor stretching west from London to Bristol. Also fairly cosmopolitan, so a young Thai lady should not feel out of place,

http://www.reading.ac.uk/education/pg-taught/ioe-primaryPGCE.aspx

Coincidentally there was a BBC news article on TV about Jenner/Caitlin as I was browsing this thread. I had never heard of him/her before, but it was interesting to compare the views expressed in the article to those expressed here.

Those readers who think that ladyboys are prostitutes and only work in Loi Kroh bars are actually revealing more about themselves than they are about ladyboys.

I think the main reason you don't see many 50+ ladyboys around is that in the 1960's, 1970's and 1980's there were fewer ladyboys in general than there are these days. Another reason is that they may prefer to stay at home just as the OP does.

Sheryl here's a link to research showing a 30% false negative rate for prostate biopsy (TRUS guided I believe). It took me 30 seconds to find; I'm sure there's plenty of other research. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668408/

The problem is compounded for men with BPH (that's a large % of men over let's say 55, as you know, and for every additional year the % is higher), because a larger prostate requires more cores which is more invasive which is more risky. And the risks are real and documented reliably on the net.

There are plenty of case histories on the net about men who have been referred for repeated biopsies - they are not hard to find.

I am not saying that what you are saying is wrong, but I am saying that the picture is by no means black and white. Differences in approach between different western countries are a testament to that.

Anyway, this thread has done it's duty, cheers and thanks for your input.

Sheryl, ok thanks, DRE and PSA and get a good doctor.

Re PSA, Richard Ablin, who discovered PSA, has described the way it's being used as "a hugely expensive public health disaster" which is not only useless but actually harmful.

Anyway, thanks to Sheryl for your opinions and to Joepai for providing the info about PCA3 in Thailand.

Best to all.

Yes I know that positive biopsies are conclusive as to the presence of cancer.

But that isn't the issue I'm raising, the issue I'm raising is due to the inconclusive nature of negative biopsies, which usually result in the urologist recommending another, and another: the risks of this are well-documented. My question simply relates to the possibility of a urologist using a method or combination of methods other than biopsy to be confident that cancer is not present. And I'm not looking for a 100% confidence level either, just as a negative biopsy certainly does not provide a 100% confidence level.

"Re biopsy, in some cases the clinical findings are such that it is very clear one needs to be done. In some cases the clinical findings are such that it is more than 90-95% clear that the condition is benign, in which case most drs would not advise a biopsy (though they would prefer the patient understand and accept that there is a small risk of midsing a malignancy)." Could you tell me which clinical methods you are referring to which give rise to a 90-95% confidence level?

I am sure you know that there are significant differences of opinion among the specialists themselves around the diagnosis and treatment of prostate issues these days.

thanks.

Hi Sheryl, thanks for your reply, I do appreciate the time you've taken on this thread. Given the incidence of prostate issues in men over 50 I'm sure many men here will find it useful.

Ok, I'm a layman in this area, but I have read the literature on this reasonably extensively and there does seem to be substantial variation of opinion about this among urologists: here are two links for example that consider MRI to be a gamechanger in this area...I'm sure I could find more, but these 2 are taken straight off the top of the google results page.

http://www.harvardprostateknowledge.org/improved-magnetic-resonance-imaging-mri-may-aid-detection-of-prostate-cancer

http://www.abc.net.au/news/2014-08-05/mri-could-be-game-changer-prostate-cancer-test/5650280

But here's my layman's question : if MRI can be used to guide biopsies and surgery to cancerous areas why can't it be used to identify the presence of cancerous areas ? (I understand that scans cannot grade the type of cancer of course, at least not today.)

You write ...

"Re biopsy, in some cases the clinical findings are such that it is very clear one needs to be done. In some cases the clinical findings are such that it is more than 90-95% clear that the condition is benign, in which case most drs would not advise a biopsy (though they would prefer the patient understand and accept that there is a small risk of midsing a malignancy)."

The 2nd occurrence of "biopsy" (the one I underlined - should that say "biopsy" (in which I case I don't understand the paragraph) or "surgery"?

And please believe me I am not focusing on the technical aspects of any diagnostic method; I am simply trying to discover whether there are any non-invasive diagnostic methods available in Thailand (ie any methods other than biopsy), and it would obviously be silly for me to ignore advances in technology. For example, if a combination of PCA3 and some kind of scan could be suffiecient for a urologist to be confident that cancer is not present, I would take that approach rather than biopsy, which is not conclusive in the case of negatives, and results in further biopsies, which do carry risks, and for some people those risks have become serious conditions.

cheers

Really appreciate your take on this Sheryl. It seems to reflect the traditional wisdom that scans take place after biopsies to guide surgery.

Ok, but biopsies frequently give false negatives, and the positives are often low grade or slow cancers that will never harm the person. I am sure you have seen the evidence on this.

Would you recommend anything other than biopsy? A urologist told me 2 days ago that a spectrum mri is as good as biopsy; he only does biopsies, so he's definitely not talking out of self-interest.

Sheryl, would be interested in whether you think any type of scan can be good for diagnosis or not. I know this is a bit of a minefield of opinion without 100 % certainty. But would welcome your opinion. Thanks.

Hi @sly, the whole area of developing standards for language users and teachers is an interesting one. And by the way, I wasn’t aware that Thai teachers of English had a requirement to be tested against the CEFR criteria, so that’s interesting news .

It seems to me that a teacher of any language needs 3 things – i. the ability to teach ii. the ability to explain the target language iii. the ability to use the target language. These 3 things are independent of each other, though they may be connected. For example even many native teachers of any language score high on iii and low on ii, and i varies enormously.

Specifically wrt CEFR: this was developed in the EU to assist the assessment of internal migrant labour, and depends upon the “can do” paradigm, ie day-to-day transactions, which may be less relevant for school children and their teachers in ASEAN than migrant workers in the EU. The main weakness of CEFR imho is that it comprises only 6 levels; IELTS at 9 (or 8 if you like) is too light, but 6 is inadequate. Nevertheless CEFR does represent a major step forward in L2 assessment, and it's greatly to the credit of the Thai MoE that they are employing such standards in assessment.

Let me quote the criteria for CEFR B2

• Can understand the main ideas of complex text on both concrete and abstract topics, including technical discussions in his/her field of specialization.
• Can interact with a degree of fluency and spontaneity that makes regular interaction with native speakers quite possible without strain for either party.
• Can produce clear, detailed text on a wide range of subjects and explain a viewpoint on a topical issue giving the advantages and disadvantages of various options.

Based on this I would say that B2 is more than high enough for non-native teachers of school-children in ASEAN; and B1 is probably high enough in most circumstances; A2 I'm sure would be fine for most Pathom levels.

I would reserve C1 and C2 for degree and post-grad level. And it's sad but true that many native speakers never get to C2 anyway !

Anyway, thanks for your post, cheers.

@brew my total chol, ldl, hdl went from 240, 175, 37 to 128, 79, 27 (since then adjusted up to a more desirable level and better ratios) in 6 weeks...

by quitting alcohol, jogging/cross-trainer 1 hour a day, brown rice with lots of fruit and veg. My weight also went to the "right" level; and naturally my overall fitness and immune system benefitted enormously. I've been vegetarian on and off for years, so that isn't a problem for me but I know it might be for some people.

I loathe taking medication, but will of course do so when it really is necessary; I've found it usually isn't

Mayo clinic recommends to aim for Total chol:HDL less than 3.5:1 and total chol minus HDL less than 130.

I've found that oats reduces total chol and LDL like magic in a few weeks.

My question is what advanced prostate diagnostic methods are available in Thailand at the moment. I would say non-advanced include PSA, free PSA, biopsy, DRE (maybe more that I can't remember right now).

Thanks JoePai.

Sheryl, a urologist told me yesterday that spectrum MRI is as good as biopsy for diagnosis of PC. There seem to be many differing opinions about this... what's your take on scans, including PET? and what's available in T-L that you know of ? thanks

Times change so quickly here. Couldn't imagine 16 years go, folk asking me where the best smoked salmon buffet was or where to buy lime scale remover

Yes, "want" pollution has arrived.

What about the guy who used to boast about being the guy who shot a guy, he still around? (all guys referred to above being of the farang variety)

Rent for a while before you commit to anywhere. Or just rent indefinitely, it gives you much more flexibility. Personally I like Lampang. I like Chiang Mai too, but the problem with CM is that it has become an expat ghetto.