xylophone

Since I was a young boy, I have taken care of myself one way or another, especially as I was a bit of an "outcast" in the very poor family into which I was adopted, as I think they regretted that decision when their second child came along. Never mind I was perfectly happy being my own boy even at the age of seven, and I never really needed anybody, and that has stayed with me all of my life. The worst mistake I made was getting married when I was 30, mainly because "it seemed to be the right thing to do", however it lasted only three years, mainly because I need my space, and my wife at the time wanted everything her way, so we parted. She was well looked after despite putting nothing into the house. I am able to cook, sew, clean and do everything around the house that a woman could, and I never get lonely, in fact I enjoy my space, apart from the times when I will phone a mate to catch up for a drink or lunch or similar, just to break the monotony. I have a few lady friends who will gladly visit and undertake a massage and anything else I desire, so life is never boring, although it is borderline boring at this time with Covid around the place. I did spend five years with a lovely Thai lady here, and her young daughter, however the urge to want to be on my own was too strong to ignore, so we parted ways and I made sure she was financially secure. Not only that, I have unofficially adopted her Thai daughter and have taken care of all her needs financially for the past 10 years or more. I'm happy with life on my own and I can't see that changing, although I'm now 74 and there may come a time when I will need someone around the place to help out, but until that time I will remain single and loving it!

With all of the practice they've had, they should have mastered the art of lying by now.

https://amp.cnn.com/cnn/2021/08/30/politics/covid-19-deaths-conservative-radio/index.html Som nam na.................................idiots.

You could add stupidity to that last sentence, and one thing that has always amazed me here is the fact that there are U-turns prevalent on dual carriageways, whereby one has to be in the fast lane if one wants to slow down to turn into the other carriageway. Why is this?? Because Thais are not capable of using a roundabout because........I'll leave it to your imagination.

So do Thai drivers!!!

Stupidity here knows no bounds.

Not sure of the point you're trying to put across, however IMO there is a great deal of difference between someone stopping because you are standing on a kerb, and someone driving past you when you are already on a zebra crossing – – something I have had happen to be on a number of occasions!

I have mentioned this before, because I don't believe that a lot of Thais know the significance of the zebra crossing (as we call it) and that they are supposed to slow down and stop when someone is on it. Add to that the fact that there are many unlicensed/untrained drivers out there and you have a recipe for disaster. Many's the time I have been on a zebra crossing and spied a car coming towards me, so have slowed down, only to find that the car totally ignores me and carries on through. I have had to warn countless visitors here that they should not treat the zebra crossings in Thailand as they treat them in their own country, because drivers here really don't know what to do with them, or give a toss.

That's quite a substantial decrease, and I have recently used that hospital and also commented on the high costs, for example I queried a cost of over 20,000 baht for a cystoscopy, and it was reduced, but not by much. Just a few years ago I met with Dr Art and he suggested I had a colonoscopy as he wanted to have a look around inside, so we booked the appointment for for a week henceforth. I asked him for a quote there and then and he stated a price of 12,000 baht. I went through the procedure and he wasn't in his room when I finished, so I went to pay the bill and was presented with a bill for 20,000 baht, which surprised me no end. So I asked why it was so high and the receptionist asked if I had insurance, and I said that I was paying myself, so she consulted someone else and they produced another bill which was reduced, and when I also stated that that Dr Art had quoted a basic price of 12,000 baht, this again caused quite a bit of consternation and paper shuffling between the staff, and they eventually presented me with a revised bill which came out to around 15,000 baht, but that included a few extras, and I was happy to pay it. Every time they ask if I have insurance and I tell them no, but they must have it on file that I do have insurance as I used it once in the past for an inpatient procedure. Now when I visit, I endeavour to buy the medicines from outside, however at the moment they can only be bought at the hospital so I'm pretty well stuck paying exorbitant prices at the hospital.

Good point and not easy to answer, because wines 10% ABV or under are taxed lower, and also fruit wines fall into another tax bracket because they have a min of 15% of fruit juice added............at least I think that is how it works!!! This wine is made by De Bortoli in the Riverlands region which produces vast quantities of cheap every day BBQ type wine, so would be interested in your opinion.

I think there are two different procedures being discussed here: one being prostate removal surgery which can have severe outcomes because of nerve and bladder damage and which was more prevalent before the da Vinci Robotic surgery machine came into being, which at the hands of a skilled operator can alleviate many of the older problems. Then there is the TURP procedure which basically "reams" out the overgrown tissue INSIDE of the prostate and leaves the prostate intact, to all intents and purposes. I posted regarding the outcomes, however BritManToo has miscalculated the results so I suggest you do some of your own research.

Your figures are wrong.

There are very different potential outcomes between a TURP and having a prostate removed. The extract below shows that there is a very small percentage of men who suffer from the side-effects of TURP surgery, whereas prostate removal surgery is a whole different ballgame, and therein lies the problem because impotence and incontinence can result, but with "nerve sparing" surgery done by an experienced surgeon the chances of these side-effects are lessened somewhat. Unfortunately before the da Vinci machine came to be, prostate removal was a bit of a lottery and many men suffered because of it. Nowadays it's a better option using that machine, but I think we are confusing two separate subjects, one being the treatment for BPH with a TURP or similar, and one for prostate removal. Conclusions: TURP had no negative impact on erectile function in contrast to ejaculatory function. Of the 109 patients with good erectile function in pre-TURP, 5.8% reported a worsening of erectile function after TURP. Among the 136 patients with ED moderate/mild pre-TURP 3.7% reported a worsening in the post-TURP, 16.2% reported an improvement, while 9.5% stopped any sexual activity. In 3.7% of the cases a complete ED was reported after TURP, while a decline of libido and sexual satisfaction was detected in all patients with worsening of sexual function. Retrograde ejaculation was observed in 48% of those sexually active after TURP. Particular attention has to be paid to the psychological aspects, both before surgery and in the postoperative period, which may become an important factor in the decline of sexual activity. https://pubmed.ncbi.nlm.nih.gov/25847889/

I did post this before but here it is again for those who may not have seen it..........it is a really good video on prostate surgery and options.

Despite an increasing age (55% of patients are older than 70), the associated morbidity of TURP maintained at a low level (<1%) with a mortality rate of 0-0.25%. The major late complications are urethral strictures (2.2-9.8%) and bladder neck contractures (0.3-9.2%). The retreatment rate range is 3-14.5% after five years. Conclusions: TURP still represents the gold standard for managing benign prostatic hyperplasia with decreasing complication rates. Technological alternatives such as bipolar and laser treatments may further minimize the risks of this technically difficult procedure.

That was a "mis-stated" part of the original report which is covered in this........... Why You Shouldn't Trust Anyone Who Claims over 80 Percent of America's Drugs Come From China A misleading statistic has made the rounds. But it’s based on a misreading of a government report https://reason.com/2020/04/06/why-you-shouldnt-trust-anyone-who-claims-80-percent-of-americas-drugs-come-from-china/

Why You Shouldn't Trust Anyone Who Claims over 80 Percent of America's Drugs Come From China A misleading statistic has made the rounds. But it’s based on a misreading of a government report https://reason.com/2020/04/06/why-you-shouldnt-trust-anyone-who-claims-80-percent-of-americas-drugs-come-from-china/ The answer is that over half of the active pharmaceutical ingredients used to make “American drugs” are made in China and India, with more coming from China. The fact is that most finished prescription drugs sold in U.S. pharmacies are manufactured in facilities located all over the world, but very few in China.Mar 5, 2563 BE https://medium.com › pharmacychecker › which-u-s-medi.

That's good to know, but from all of the research I've done I would go with the Urolift procedure, IF it was my prostate playing up!

Thanks for your good wishes, however I don't think it has anything to do with my TURP procedure of many years ago, because it was over 10 years ago and I was peeing fine until about a month or so ago, and I don't know what has caused this, and nor does the urologist, however I think it's a different situation with regards to what you are experiencing now. The meds like doxazosin and others will relax the prostate and bladder muscles, however the overriding situation is that your prostate is enlarging, and the meds probably won't stop that, just ease the situation with it, until it becomes basically unmanageable. As I said earlier, if my situation was purely about the prostate enlarging, and thereby restricting the urine flow, then my first option would be the Urolift, even if it meant going to the likes of Dubai (or Australia, or the USA) to have it done, and the universally tried and trusted procedure of the TURP would be the next option (again). In the main the TURP operation works for the vast majority of men, with just a few experiencing some side-effects, and retrograde ejaculation is probably the main one (in a small percentage of men I may add), however it doesn't stop the "enjoyment" of sex, it just means that the semen flows back into the bladder rather than out of the end of the penis, which doesn't feel any different, but is less messy!! As for me, well I'm searching for ways and means to get the bladder working again, but it's a long hard road at the moment. I would be happy if it was just a prostate problem, but it doesn't seem to be.

I noticed that BritManToo has mentioned doxazosin as a treatment, and it can work, mainly because it relaxes the muscles in the prostate and bladder, thereby allowing urine to flow more easily, but for many people it is only a temporary measure. If the prostate has become so large that it blocks the prostatic urethra, thereby restricting urine flow, then surgery is perhaps the only remedy, and because we live in Thailand, the TURP (or the equivalent by greenlight laser) is the only option we have, although as I said previously I would opt for the Urolift if it was here – – – but having said that, I have found out that it is available in Dubai and Singapore, if one could get there. I was thinking of going, but the problem I seem to have now is that I cannot pass any water whatsoever so I'm having to self catheter three times a day, and have been doing this for about a month, despite having ultrasound and a cystoscopy, and nothing showed up, although I was rather hoping it was the prostate growing again so that I could get it fixed, but apparently it's not. The urologist called it neurogenic bladder, which for some reason means that the nerves in the bladder wall and signals from the brain are not coordinating to allow the bladder to empty, so I have got more research to do, because the urologist here doesn't know what has caused it! Doesn't give me much hope. If you can see a good urologist, he will be able to recommend a course of action and will know whether more/other meds will do the trick, or if an operation is necessary (only just seen your post re the meds).

The TURP (transurethral resection of the prostate) is the most commonly found procedure here in Thailand, which can alleviate problems associated with BPH (benign prostate hyperplasia) and it is considered the gold standard in the urology world. Most largish hospitals here will be able to carry out a TURP. I've had one in Australia although it wasn't without its "problems", and I have been experiencing problems again so have looked at two new procedures, the steam treatment called Rezum and another one called Urolift (which is my preferred option) both of which are relatively quick and painless and don't involve surgery per se. BUT not available in Thailand.

Totally agree with that statement as it was a total waste of money, equipment and lives, this after the death of Osama bin Laden. Yes, a lot of American military hardware has been left behind, and I would suppose a lot of it is not worth salvaging, but on that point, the military leaders (you know the high up leadership) had they been worth their mettle would have ensured that either the equipment got back one way or another, or it was blown up. Throughout all of this, the military leadership has been dreadful, and I can't blame any president for the fact that they've got some pretty dumb people in charge of the military and it is they who should be held responsible. The old saying that the term "military intelligence" is an oxymoron was never more true.

Be careful if parking outside, as parking on the red marked road will get you chained up! Saw a car yesterday with a chain wrapped around the wheel and door............easy money for cash starved BIB!

Yes, you make good points, but overall they were wars that the US shouldn't have been in, and the "suppressing communism" was as much an ideological thing as anything, and sure enough, Afghanistan was a terrorist base, but then again so was Pakistan! The overall picture, on which I think we both agree, is that it was totally mishandled and inept war, and one which you quite rightly state should have ended once bin Laden wasn't there, and trying to build a nation in a country such as Afghanistan with its mediaeval customs, warlords and whatever else you want to name, was always going to be a nonsense. However it seemed to benefit many in the American military, many advisers and hangers on, not to mention the Afghanistan hierarchy, and so it went on – – such a shame. This is an interesting article from the NZ Herald: – https://www.nzherald.co.nz/world/billions-spent-on-afghan-army-ultimately-benefited-taliban/QWWDYHJG7ACSYTGV7GFHAPVPHY/

Well he was on a hiding to nothing wasn't he, because the wind down in the military was agreed before his tenure (in February 2020, President Trump and NATO allies agreed to formulate a deal with the Taliban, allowing for a formal withdrawal of US combat forces from Afghanistan. Under the terms of the agreement, the Taliban promised "not to allow al-Qaeda or any other extremist group to operate in the areas they control." The deal, titled the "Agreement for Bringing Peace to Afghanistan", saw US and NATO forces withdrawing in earnest and set the deadline for a complete withdrawal of US forces by 1 May 2021) so although it is happening on his watch, that is not the whole story. For years there have been stories of huge corruption in Afghanistan, where the US and allies pumped hundreds of billions of dollars into the war effort, and for the most, the US government, military and other advisers turned a blind eye to it. One has to ask how the US and others spent 20 years and hundreds of billions of dollars "training" the Afghan military to be a fighting force to protect the country, only to see it crumple like a house of cards. It asks a couple of questions: – just how effective was the training, and irrespective of any training, did the Afghans have the courage and mettle to be able to fight for their country. If you add into that the corruption which ensured a great deal of the military, police force and others were unpaid, due to their own corruption, and it becomes a self-fulfilling prophecy. It was yet another war that America (and its allies) had had no business being in, but the lessons of Vietnam were seemingly not learned. This was a complete failing of the American military and its advisers, which is such a shame because it sacrificed so many young American lives (not to mention the many Afghan citizens who died over the 20 year period) on poor principles, bad advice, corruption and total ineptitude,