Sheryl

5 minutes ago, PJ71 said:

I'm not a doctor but you'd be surprised how much a strict diet and a reasonable amount of exercise can improve your health.

 

This is from personal experience.

It will do him all manner of good to lose 5-10 kg and be more active. But it will not necessarily reduce his LDL by much. 

47 minutes ago, tomgreen said:

 

At home use an Omron HEM 1730 model blood pressure monitor . At my age ( 74 ) I'm amazed that my blood pressure numbers are always within the general '' Normal '' range.

 

Ive tested the same Omron HEM 1730 model blood pressure monitor on family members , and those results were all different ( which I expected ) . When I go to Hospital for a blood test , my blood pressure is always shown as a bit higher than taken at home. 

 

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That is to be expected due to the stress of being at the hospital.

Omron is a good brand.

Your BP is perfectly normal. 

1 hour ago, tomgreen said:

 

Thanks for the article link , I wonder why that study is not more commonly known ?

 

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Because this is not a reputable site and it quotes not a scientific journal but another unreliable site (Daily Mail)'s out of context version of same.  

Regarding last visit recommendation to take 40 mg atorvastatin: if I understand correcty you previously took 20 mg and it was effective. No reason therefore to take 40. Should always take the lowest dose necessary.

It is sounding like the doctors you see are not really looking at your history when making recommendations. You may need to be more proactive in drawing their atrention to it (prior lab results  prior med dosages etc).

Get another creatnine and BUN  test and I would slso suggest electrolytes  (sodiun  potassium). -- only these tests not others so   no need to fast before hand which should remove any effect due to dehydration. For a few days prior make sure to drink enough that you urinate with normal frequency and amount and your urine is light in color (light yellow not completely water-like)  but don't overdo it beyond that point.

there are some stand alone labs in Korat such as https://www.rtlclab.com/?fbclid=IwAR096QM1ywmb97tvgqCfuq8SDmregTgojHgJulniPkvJRW-VYJb4yXgBLfw

I don't have any specfic info on their quality, maybe other Korat residents can advise.

If your creatnine  is still elevated consult a nephrologist.  I'd suggest Dr. Watanyu Parapiboon at Maharat (majn govetnment hospital in Korat, much bigger than Suranaree) going through their "after hours" clinic. 

Yes elevated LDL is often genetic and since you are not diabetic and your triglycerides are normal likely true in your case ...though it would help to know your weight/height, activity level and diet.

Don't forget the fish oil.  You want to get your HDL (which is protective) up preferrably to about 70. 

7 hours ago, Kinnock said:

Thank you for the very helpful and wise advice. 

 

We've already arranged for the Mother's house to be improved (basically rebuilt) to make living on the ground floor possible, and if she's coming home we'll order a proper hospital bed etc .... but I think I"m just disappointed that my wife seems to have taken on the total responsibility when there's three older siblings doing nothing to help. 

 

I guess I was looking for a valid reason to not let my wife take on the tough challenge of being a carer.  

 

I think it may be Thai culture that the youngest daughter does all the work .... or maybe just the daughter with a foreign husband.

 

Not always the youngest daughter. Many factors go into who in the family does what.

Perhaps the other siblings have other commitments that preclude being fulltime caregiver. Or perhaps your wife simply has the bigger heart. 

You don't want to get too much in the middle between your wife and her family but perhaps you could gently suggest that the other siblings chip in to pay for live-in household help. Split 3 ways would not be that much. Not reasonable to expect your  wife to keep house, cook, shop and care for her Mom single handedly. She'll need at least one other pair of hands. 

The situation will evolve one way or the other. Her Mom's condition may continue to improve. Or her Mom may not live that long (likely a thought in your wife's mind in deciding to go so far away). You and your wife can reappraise options further down the road depending on what happens. 

For now just be supportive  

There is no reason at all to think she has dementia. Vascular dementia occurs very slowly not suddenly.

It is quite common after a stroke to have trouble (or inability) speaking and you may be mistaking this for dementia.

The aphasia (inability to speak) may or may not improve with time. Improvement after a stroke can continue for up to 6 months and is gradual. Not speaking after a stroke  does not mean the person does not understand or recognize people or that they are demented.

Keep in mind too that being on a  ventilator itself interferes with speech. 

It is significant that the medical personnel caring for her -- who will have seen hundreds or more of such cases -- do not  suspect dementia. 

She is more likely to improve in familiar surroundings  than in an institution, and it is not customary in Thailand to put parents in a nursing home.  Millions of  Thai homes have elderly people with incontinence and other issues in them, cared for by family. (And with hired helpers  if the family can afford). Yes it is a strain but so is caring for an infant. And feeling that one failed in one's duty to a loved one is an even greater burden. So let your wife do what she feels she must and try to be supp8rtive. Maybe offer to pay for some in-home help (but let your wife decide how best to utilize that person). 

Ventilator care is of course more difficult in the home  but they will probably not discharge her unless/ until she is able to breathe on her own.

It is not possible to make a diagnosis via Google, even for a trained health professional.  The search engine is not designed or  constructed for it.  

It made no sense at all to stop the atorvastatin when it was clearly having the desired effect. Naturally your numbers went right back up. That's what happens. These are long term medications, not ones taken just until the labs improve and then stopped -- that is completely crazy and it is incredible that a doctor would advise it.  I would definitely stop going to that doctor. 

The only reason to stop would be if you had intolerable side effects (and even then, a different medication might be advised in its place). 

Countless people take statins long term and 20mg is a low dose of atorvastatin (but appeared adequate for you). 

I am surprised nothing was said about your HDL which is too low. You should eat more oily fish (mackeral, tuna etc) and/or take fish oil capsules to get that number up.

Beyond that I cannot advise re your diet without knowing what you currently eat. 

Cholesterol aside,  your abnormally high creatnine is worrying and suggestive of kidney disease. You need to see a nephrologist. Sooner rather than later. 

Where in Thailand are you?  And where have you been going for health care? (You need to change it, for sure.) 

You are not on a strict no sugar diet (or any sort of no or liw sugar diet)  if you are eating fruit for breakfast. 

With fasting sugars well under 100 in the morning and a recent episode of hypoglycemia midday, I suggest a more substantial breakfast. In particular more protein and some healthy fats. This will help stabiluze  your daytime blood sugar. 

1 hour ago, Bangkok Barry said:

 

This is incorrect. I was talking my local IO, questioning exactly this, and he told me that you are allowed to work with a retirement extension. The conversation happened when he was trying to persuade me to have a retirement instead of a marriage extension. Whether you work or not has absolutely no relevance as to whether you qualify for a retirement extension. All they care about is seeing 800,000 in the bank.

You are most definitely not allowed to work in Thailand on a retirement visa/extension. 

Work outside of Thsiland yes but in Thailand no.

Irrelevant to this story as the man in question is on a business visa.

3 minutes ago, eisfeld said:

 

It is more difficult for americans as other nationalities at some banks. Some banks refuse americans but accept others. The banks don't want the hassle with the US. Of course it's also more difficult for foreigners to open accounts than locals. But americans are again a special case.

Again, no Thai Bank as such (meaning entire Bank corporation) has a policy of refusing Americans.

This is being done on an ad hoc basis by some branches  or even just some bank staff because they are unwilling or afraid  to deal with a new (simple, short, and filled out by the customer) form.

Try a different bank or call the bank HQ number and have them explain it to the staff.

There is no high level nationwide bank policy of this sort.

Rather bank branches got instructions from their head offices on additional form to fill out in the case of a US account holder. Not in fact that complex a form. But of course, in English and unfamiliar to them.

Typically, some are afraid or unwilling to follow this and opt to just refuse to open account.

Try a different bank.