Sheryl

Pam, also go to this link and see post #3

Sripat would be able to do this. I'd suggest you go ahead and get not just the biopsy but specific treatment recommendations from docs in your home country before flying back, it will simplify matters.

There is no definitive evidence that B12 supplements increase the risk of cancer. various studies have foun d different thin gs and often not been duplicated.

See this libnk fior a complete review of what is and is not known:

http://www.mayoclinic.com/health/vitamin-B12/NS_patient-vitaminb12/DSECTION=evidence

Glad to hear the surgery went so well, pam.

Craig's leads look worth following up on. To contact the person he mentions in post #8, click on the link and then when you get the member's page, click on "send a message"

Thanks Phil. That appears to be these folk http://pattaya.olxthailand.com/nursing-home-service-iid-261771661, the web page has a skype address and email

I'm in the same boat, my father died of Alzheimers and everytime I have a "senior moment" I mildly panic. So i follow the research very closely.

Everything Nancy said re diet and exercise is correct. Plus, there is some evidence that low levels of B12 (as can occur in older people) is a risk factor and that niacin supplementation may be helpful. Personally I am taking a high potency B complex that includes 60 mg niacin. I also take separately sublingual b12 but that is because I am a vegetarian,. might not be necessary otherwise but it would be good to check your B12 levels (a simple blood test can do this).

BTW your Mother should see a neurologist specializing in AD for evaluation. There are drugs (Aricept etc) that slow the progression of the disease and they work best if started early. there is also a new nutriceutical" product called Axona which improves cognitive functioning in AD, a similar benefit may be obtained by taking cocount oil daily but this has not been scientifically studied. . Note that this is not a preventive -- it just helps reduce symptoms once AD is present. this is because in AD the brain's ability to metabolism glucose is reduced, and coconut oil (and the medication Axona0 contain a type of fat that convertys to ketones in the boidy which the brain is able to utilize as an alternatiove to glucose). See http://alzheimersweekly.com/content/axona-mct-coconut-oil-differences-benefits

I'd suggest you contact Romrawin clinics I(they have a website0 and ask which of their doctors has the most experience in this area.

Ii is also available under brand name Basalin, produced by a Chinese company (Gan & Lee) and distributed by Zuellig. Might be less expensive than the sanofi brand, but I have no idea about reliability of quality.

Zuellig Pharma Ltd

8-9 Fl, Ploenchit Center

2 Sukhumvit Rd

Kwaeng Klongtoey

Khet Klongtoey Bangkok 10110

Tel: 0 2656 9800

Fax: 0 2656 9801

Email: [email protected]

Website: http://www.zuelligpharma.com

Suggest you contact both Zuellig and Sanofi for price quotes.

Valproate and phenytoin are available in locally made brands so sheap. Topiramte is only available as Topamax, imported, so expensive -- probably a but more than it would cost in Europe, Canada or Australia but less than in the US.

Sorry I can't be more specific than that.

It is likely that there will eventually be a locally made version of topiramate, but may take some years.

If anyone can suggest someone please reply in the above post, it is for a man having surgery for oral cancer

Dear Pam,

So sorry to hear of this circumstance. We usually don't allow for multiple postings but in order to maximize chances for a reply I have put a cross referenced inquiry in the Pattaya Forum.

Where is he having the surgery?

Some hospitals have home health care units which can provide such staff, but it will cost more than if you can arrange to hire someone privately.

I know Sikarin hospital in the bangkok Bang na area has this. In pattaya, I think Bkk Pattaya Hosp does but likely to be very expensive.

in Isaan, your best bet is Khon Kaen University hospital. (Srinakarind)

http://www.facebook.com/pages/Srinakarin-Hospital-KhonKaen/141770422538969 for map

Bring a Thai speaker with you for first visit as the registration process can be daunting. Arrive early and be prepared for long waits. Once you have been registered at the oncology clinic, follow up visits will be easier but still entail long waits.

And of course bring your medical records with you to avoid unnecessary repeat tests.

In a malpractice suit, be it here or anywhere else, the key issue is to show serious harm as a result. What could have happened doesn't count, even if there was indeed neglogence on the part of the physician. Only what did happen. As you have not suffered paralysis, loss of a limb, or death, you are not in a strong position in terms of winning much in damages, and indeed it might be hard to win more than you would have to pay the lawyers. And, of course, if you lose then you are out the legal fees altogether.

I think as regards the government hospital there is no hope. . With the private hosp[ital, possibly you could get them to settle to avoid the bad press of going to court, but no guarantees.

I've been in Thailand for years and never had the rabies or Jap E vaccine. I haven't had the rabies vaccine because the chances of needing it are relatively low, and if you are bitten you still need some post-exposure shots whether you've had the pre-exposure shots or not. I think 5 post-exposure shots are required if you haven't haven't already had the vaccine, and 2 or 3 if you have.

Hey, you failed to mention the necessity of a human or equine gamma globulin (HRIG or ERIG) shot in addition to the 5 vaccine shots required for post exposure treatment of rabies.

As far as I am concerned one of the main reasons for having the pre exposure vaccination was to negate the use of HRIG or ERIG ( both blood products) which are sometimes difficult to obtain or not available in parts of Thailand.

sanuk

Yes, and in addition they carry a risk of allergic reaction which can sometimes be serious. Well worth avoiding. (However for someone who did not get the pre-exposure vaccine, should not fail to get it -- the alternative is much worse).

All three are available here. Phenytoin and valproate are available in inexpensive locally made versions, but topiromate is available only as Topamax, an import and tbus expensive.

If you are not going to be staying in rural areas then it would not be unreasonable to skip the japanese b, the resevoir for this is pigs so it is found near areas where pigs are raised.

Rabies on the other hand, I would definitely advise. lost of stray dogs everywhere are rabies is endemic here.

thanks for the update, and good luck.

yes, the drug is prescription only.

2 very different things are starting to get confused in this thread: use of finasteride for male pattern baldness, and use of it in treatment of benign prostatic hypertrophy.

Same drug but totally different applications involving different dosages.

Oddly enough he didn't give me the price list for surgery, which i was kind of him expecting do - shove a price list in my hand as he shoved me out of the door! i was wearing tatty jeans and a worn out t-shirt, so I guess he thought i couldn't afford it!!

More likely it was because surgery is not indicated for this condition.

ilitibial band syndrome is treated by avoiding certain activities, gentle stretching of the band, and compression (google McConnell's Taping -- there are some videos on you tube that show exactly how to do it).

In some cases orthotic problems underlie it in which case appropriate orthotics may help.

In severe cases that do not respond to these measures, steroid injections are sometimes used.

Surgery doesn't enter into it.

Sounds like you may not have seen a specialist in sports medicine. Suggest in future taking time to select a specific doctor, otherwise may indeed just waste your time and money. One cannot rely on the hospital to refer to the best doctor. In fact sometimes they will even send you to altogether the wrong type of specialist.

Yes, they are, but for what he wants (general anesthesia for minor dental work), there isn't a low cost option.

You can get everything here on demand, but in some cases it would be wiser to start the series before departure.

The most important vaccines IMO are hep A + B and rabies. Depending on your age, you may already have been immunized for Hep A. Check your records.

If you are going to be in rural areas much then Japanese B encephalitis is worth considering.

Within Siam Square (opposite Siam World etc and inside the rabbit warren of little sois) there is at least one excellent book store with medical texts.

If tinnitus is caused by medication then yes, stopping the medication should relive the symptom.

Tinnitus is uncommon with enalapril but has been reported in rare cases.