Fore Man

I am also on statin drugs and I find the benefits questionable even though I don't notice any serious side effects. However, do not just stop your statin drugs cold turkey! See a doctor if you want to. There is a high rate of mortality for people who just stop taking these meds.

Yes, I will do as you suggest...good advice. Thanks.

fore man

I had much the same problem from taking Lipitor. I quit after a month and all the symptoms cleared up.

Now I take Niaspan 500mg daily with no side effects, have been taking it for about six months. It is not a statin-class drug. You might ask your Dr. about it. Have not have my cholesterol checked since I started taking it.

Thanks, BTDT! I haven't looked into a replacement cholesterol-controlling medication. I'll look into this, but want to see how my lifestyle changes will affect things.

You know, my former LA-area doctor, an old golf-loving GP, told me in plain English about 12 years ago (paraphrased):

"Look, I know you are a disciplined person who can probably control his diet well, but with Lipitor, why worry anymore? Eat and drink what you like and let the medicine take care of things."

With dozens and dozens of patients taking the same drug, I wonder what his advice would be today on the same issue...

I'm currently faced with the same dilemma. Although i haven't made the purchase yet, it's my feeling that probably the best bet is to buy a separate fax machine - about 3,000 baht - and then get a dedicated printer - for that i'm thinking a colour laser printer.

My reasoning is that most of the 4 in 1 printers that seem to suit my needs and budget are inkjet. Bearing in mind that for me, the printer may sit idle for weeks at a time, inkjet could end up being a false economy as one would have the hassle of changing / refilling cartridges often.

And the advantage of buying separate machines is that being dedicated, i think they might do a better job - also, if one breaks down, you still have use of the other machine.

All in ones seem attractive, but in the long run i'm not so sure...

A good point! I use the HP2210 All-in-One machine but primarily for a lot copying, some scanning and a bit of faxing. It is my back-up printer but I rarely use it for printing, as I have a stand-alone Canon inkjet (also 5-years old) which serves my needs well. Like my HP, I have had that Canon repaired in Chiang Mai twice by the local service shop and in both cases they did a great job.

A note of possible interest to other TV members who are Lipitor (or similar statin-class drug) users. I have been faithfully taking between 5 to 10-mg daily for the past 10 years. For the most part, I tolerated the drug well...as you would think in such a small dosage. Undeniably, using Lipitor has maintained my cholesterol at proper levels (140-190). But over the past 24 months, I have come down with several new symptoms/problems, which were inexplicable and which caused me considerable discomfort. These were: Restless legs Syndrome (RLS), muscle spasming, loss of strength and a bad case of what was misdiganosed locally as psoriasis on my fingers. The latter turned out to be exfoliative keratolysis, a condition where the skin is constantly peeling, growing new, denser skin and then cracking and bleeding before healing again...a vicious continuing cycle.

I began to scour the Web for leads on what might be causing these maladies, and came upon a startling discovery that there are thousands of Lipitor (and other statin class drug) users around the globe who all have presented one or more of my individual symptoms. To a person, those posting on these various sites have all found relief after ceasing all use of these medications. Lipitor was the primary medication being commented on by these posters, as it is probably the most well-known and prevalent drug being used to control serum cholesterol. It is also rather costly as well. As an experiment, I stopped taking Lipitor three weeks ago and found that all of my symptoms are suddenly on the wane. The RLS episodes have stopped completely, helping me to get better sleep ; my skin seems to be healing normally now; my muscle aches and spasms have stopped as well. Were these problems due to Lipitor? Who can tell? I only have my empirical results to consider and it looks pretty much like Lipitor was the culprit. I changed nothing else in my lifestyle. I have also been dealing with chronic GERD over the past 10-12 years and now those symptoms also seem to be ebbing.

All I know for sure is that I have started to feel a lot better lately after a long period of decline.

If we stop taking these accepted medications, what do we do to control our cholesterol? Aside from cutting back on fatty foods and those that are known to increase serum cholesterol levels, I have learned since that there is a great deal we can do to keep LDL levels at bay...including Vitamin C, Lysine and Omega-3 therapy; improving HDL levels through proper exercise and avoiding certain foods and adding others (such as oatmeal and fish). I plan to have my blood checked again in 6 months to see if my lifestyle changes are effective in controlling my cholesterol levels.

Finally, there is now some belief that perhaps cholesterol is not the culprit we have always been led to believe it to be, and in fact by artifcially restricting cholesterol levels, we may be creating more injurious effects.

I am not a physician and do not advocate that TV readers stop taking Lipitor and other statin class medications...I simply want to air my own experience and let others decide for themselves what courses of action they might want to consider. Including performing their own research. A physician whom I consult occasionally back in the USA has agreed that Lipitor could have caused my problems but is not prepared to advise that I stop using it entirely...he is admittedly not trained in natural remedies and only sees that so many of his patients have substantially lowered their cholesterol levels by using statin medications. By that single benchmark it is hard for him to repudiate its continued use unless specific blood chemistry reactions dictate otherwise (such as liver or kidney damage).

It is a very complex and confusing issue indeed. If any TV readers have examined this issue and have formed thoughts about it, I would be interested in hearing from you, either via the Forum or by PM.

I have found the brand with initials HP on it to be the only option. Tried them all in the past and HP is the only one that actually lasts....

Concur...I have been using an All-In-One HP 2210 for the past 5 years and it has been practically flawless. I experienced some weird delays in copying documents a month ago, and was quickly and expertly assisted by HP's Thailand on-line support site. HP's on-line library of various tech tips and patches is always helpful as well.

Scientists Discover Inverse Relationship Between Expats’ Income and Thai Fluency

<snip>

I find some of these findings, or perhaps the manner in which they were articulated, to be rather offensive. I would tend to cut through all the hypothesizing and believe, rather strongly, that an ex-pat's fluency has nothing to do with his income. It is first and foremost a matter of priority...those who are motivated to learn Thai will do so..for whatever provocation. I happen to be at the upper end of the income spectrum, but speak, read and write pretty fair Thai. An older person, I am always trying to learn new words, phrases and idioms to add to my knowledge. I have a Thai wife who encourages me to do so. I've even studied under monks to sharpen my abilities in the language. I'll never be even close to native fluency, but that's not really my goal...simply to increase my enjoyment of living in this Kingdom on a daily basis. I have several acquaintances in Thailand who are equally well-paid and equally fluent...and none of us are "diplomats, consultants, and specialized UN and development workers speaking [sic] fluent Thai despite being paid huge international salaries."

I also have some low-income retiree friends who haven't learned much Thai and it is not because they are "near destitute" and '...waiting to die, preferably beneath a once-a-month rented sex-worker.” That is repulsive and debases all elderly expatriates who live here simply and with good moral behavior. I have found that acquiring a language skill requires a great deal of aptitude to do so as well as a matching desire to learn. Many of my friends--rich or poor--simply do not possess this special aptitude and do just fine without it. They also make up for this in many other ways with various talents and abilities.

It sounds to me as if some academics received a research grant and consumed all of its funding to build a shoddy case that is based on a lot of supposition and preconceived notions. Shame on that. I would also have to argue that their findings may be statistically insignificant.

I live fairly close to the usual flight routes of the ultralights near Doi Saket. However, for the last month or so, I haven't seen or heard any flights. Yes, the visibility has been crummy for photo shoots -- but certainly not near minimums for visual flight operations.

Are they still in business?

I've observed several overflights of our area just east of Mae Rim along Hwy 1260 and these were powered paragliders...they originated from some point south of Mae Rim and tend to make a 90 degree turn to the east at Mae Rim...roughly over the Green Valley Country Club...where they fly on in an easterly direction from there. Not sure of they head all the way over to Doi Saket or not. I always wondered who these pilots were, until one day we saw them landing at the RTA Special Forces Command base along Hwy 107 south of Mae Rim. If you are seeing fixed wing ultralights, then they are a different matter and I rarely see them in our area any more.

As for complying with VFR, I doubt they are required to do so...especially given that TIT and they are operating in uncontrolled airspace (to my knowledge anyway). If they are Royal Thai military pilots, then I am doubly sure the usual Thai VFR requirements are not applicable.

Can anyone help with a little inquiry?

My latest 90-day report expires on 5 April. I am also due to fly out on a business trip the same day. Do I need to submit another TM 47 on 4 April or just stamp out the next day. I realize that upon my return the 90-day clock will begin anew upon my arrival. Thanks.

You get 7 days either side of the date. The Immigration website says report if you are staying in the Kingdom over 90 days. As you sre leaving on the same date I do not think you have to do.

Thanks, LB...I didn't realize this little quirk until now...usually am gone on frequent business trips and never need to submit a TM 47.

Can anyone help with a little inquiry?

My latest 90-day report expires on 5 April. I am also due to fly out on a business trip the same day. Do I need to submit another TM 47 on 4 April or just stamp out the next day. I realize that upon my return the 90-day clock will begin anew upon my arrival. Thanks.

I recently came downstairs half awake one morning, walked past my desk, only to be confronted by a reasonably large and agile snake coming down from the top of a tall cabinet just behind where I sit. It then hid underneath. As I'm quite phobic about snakes - it was quite a shock. I woke the wife up, who knowing about my fears, called father in law from next door. In his well meaning way he then proceeded to poke at it with a short stick. Much hissing and attempts by the snake to hide even more ensued. Anyway, a neighbour with some snake experience made a loop on a long pole and an hour later removed and released it across the road into a canefield from where it had probably originated.

To the point of this post - I have tried to identify it from various websites on snakes in Thailand but without success.

Description - about 1.5 metres long, as thick as a piece of regular size blue plastic water pipe or maybe larger; black and white small chequered markings all over; a small head, and scared rather than aggressive. It also moved quite quickly. I haven't discounted the idea of it being a young python, but I'm not sure. It was definitely not a cobra. Does anyone have any ideas ? and venomous or non venomous ? We live near Nakhon Sawan, so there are many different varieties of snakes around.

That's a big snake! I can't help you with ID, but am curious how the snake got to where it was before it dropped to the floor. Do you have an A/C mounted on the wall over that cabinet? If so, it may be possible for a thin snake to enter the water condensation pipe...if it terminates outside at a level that could be accessed by a reptile. We had this happen to us a few years ago. The snake turned out to be a young krait according to the Thai A/C repairmen who came to pry it out of the machine and end our panic. If there is no apparent access portal adjacent or above the cabinet you mentioned, you need to think through how it arrived there and why. Weird.

I have found out the hard way that IE7 runs fine once you disencumber it of certain retardant plug-ins...such as a controversial Java update. Once I got rid of that single plug-in, my IE worked tons faster!

No, there really is a problem with the metered taxis in CM. The last time I flew in to CM via international, it was 1am, and all the metered taxis would only take us for a flat 200B or 250B, cant remember. They refused to use the meter. One even laughed at us and said, "where you going to go, theres no one else". That made it certain that I would not use him, got the TGF to talk to a red song taow and off we went. Airport taxi flat fee my arse. Same thing each time I call one to pick me up, they always state a flat fee.

edited for grahammmer

I have to disagree in part. I routinely take trips outside of the country and return to CNX. On the occasions that my wife cannot pick me up, I take a metered taxi. It is ALWAYS a flat rate of THB 360 to travel to my home well north of the city. We have taken 'metered' taxis in and around Chiang Mai on occasion when our one car wasn't enough (we have a large family and occasionally using a taxi makes good sense). The driver ALWAYS set the meter but this was during busy business days, not at nights. My understanding of their costs makes the THB 360 a fair one and I don't argue...it is the standard rate for all metered taxis from CNX out to Mae Rim. If they would try to gouge me for more (they ever have) I would have to negotiate the fare. Moreover, my Thai wife and/or daughter has arrived at CNX and always been presented with exactly the same fare...they are not trying to cheat a Farang at all.

However, that being said, I was told that if you arrive late at night, they will not want to use the meter and will assess a flat rate. This flat rate is based somewhat on where you want to go in the city and the driver's assessment that he can or will not be able to find another fare close by your destination. He also has to factor in the trip to the airport to pick you up if he is not already there. There's not a great demand at 1 AM from the airport.

One of our friends is a taxi driver (metered Isuzu) and he explained that all local taxi drivers are feeling a strong pinch from rising fuel prices and the taxi company's take. The fare basis hasn't been increased accordingly to reflect reality. Most drivers work horrendously long hours as it is to try to make a decent living and then it is still not enough. I wouldn't chalk this up as greed or intransigence at helping a foreigner. Act like a typical arrogant, holier-than-thou Farang and you will get it back straight away. Act friendly and they will act friendly back and be more willing to negotiate a fair flat rate. Not always of course, but keeping a friendly demeanor and smile on your face definitely helps.

I guess the real issue is this: is paying an extra THB 50-100 that much of a sacrifice at 1 AM to take you in a dry, safe (well, safer) vehicle to where you want to go? Or would you rather stomp away angry and feel as if they are always trying to cheat you?

I have never had a problem getting a metered taxi. And I never use one that refuses to use the meter. Fares are fairly standard, such as from the airport to the city or out to Mae Rim. THB 1,000 to go to Doi Suthep seems kind of high. We hired a van and driver last week when friends visited CM, using him for a 12-hour day. He was a friend of a (Thai) family friend so that helped a bit, but that price range is about right anyway. He drove us all over the place, taking us to Doi Suthep, Doi Pui, downtown for dining etc all for THB 1,500 plus his fuel--about THB 350. I sense that you are trying to do this without the help of a Thai companion; having one along will definitely lower the fare. Without one, you are at the mercy of your conversational Thai and your ability to strike a friendly bargain.

ForeMan, I simply went to American Consular Services (in Chiang Mai) and submitted my application. It was sent by diplomatic pouch to the office in Manila. Six months later, I got six months back payments. Maybe it was 4.5 months later. The delay was not in Manila, but later in Baltimore.

Thanks PeaceBlondie. Good to know this is possible and I hadn't really given that option any thought. Another long-time American expat in CM advised me that he simply mailed off his application to the Manila office. I suppose it can work either way.

Yikes, I'm almost 62 and have just filled out the lengthy online form for American Social Security, but i hesitated clicking the 'submit' button until I get some answers to a few concerns.

1] There was no provision for using my Thai address so I used my brother's Hawaii address, both as a physical address and mailing address. I already use his address for my personal, banking and business matters and he forewards correspondences to me....so I guess that it's ok.

<OP truncated to save space>

What about this first question posed by the OP? I don't have a USA address to use in applying when I begin benefits. How do you skirt around this issue? Thanks.

some of the feng shui principles I like, and some I don't

Out of curiosity, which principles don't you like ?

BTW, excellent post Fore Man

Thanks for the kudos. I also see the point made by Pierrot in having to live with our decisions to adopt Feng Shui principles. The only real difficulty I had in buying off on the concept had to do with how the front car gate would be positioned along the roadway that parallels our house. We live at the junction of a three-way intersection. The front of our home directly faces the street that forms the 'T' intersection. Our FS master strongly suggested that we could not build our driveway entrance and gate directly in the path of that oncoming street...perhaps as we would do in the West. By doing so, it would allow bad spirits to simply sweep into our home without any impediment. I was in great favor of erecting the gate so we could drive directly forward off that access street into our driveway instead of having to make a turn onto the street paralleling our home and then another turn into our driveway. Which in the end is exactly what we ended up doing. My wife was adamant that this was a 'must' in the front wall and gate design and she would not be comfortable with my original idea. The FS master said we could do it my way, but we'd need either a mirror positioned on the gate to 'reflect' bad spirits or some kind of water fixture (trough or fountain) along the wall on the sides of the gate. I acceded to my wife's preferences--after all this is her country and her culture--and after it was all said and done, I am pleased with the result. I quickly learned that having to make those two little 90 degree turns to get into our driveway is not really the nusiance I thought it would be. And everyone is satisfied, surely the most important factor.

It's not a matter if we Westerners believe in Feng Shui or not. I was sort of ambivalent to the whole idea myself during the design and construction of our large home built in CM over the past 2 years. At my wife's request, we hired a FS specialist to make sure the design would be acceptable to Thais. In the end, it was time and money well spent (the cost was minor); we have a more open design that accommodates FS concepts and most importantly, my wife and her family are all very satisfied that the home was designed and created in the right ways. As we all realize, Thais are extremely superstitious and violating a FS principle is not something you do here on a whim. Moreover, if we ever need to sell this home, it will be tons easier to unload than if there were a lot of FS faults in its design that would be unacceptable to most Oriental buyers.

Most TV readers live in Thailand and many have married Thai women...this brings a whole new set of obligations and expectations into the equation. I for one don't resent any of these and simply have come to accept and adopt them.

I used to share a house behind Central Silom, great place 4 beds, reception room, carport for two cars, all for the princely sum of 25,000 split three ways!

However this was a house in a public soi, we were broken into 4 times in one year. This was despite installing alarms (the type which call through to a central monitoring station) and motion sensitive security lights after the first event. Police reports were made... but .. well you can guess the rest...

However, I have never had a problem whilst living in a condominium, or since moving to a house in a gated community. I honestly believe the difference is made by security guards. Not that they do much per se, but so long as they patrol, take names, and id cards, they can serve as a good deterrent.

We live in remote but gated community in Chiang Mai. Last year, there were 3 or 4 break-ins perpetuated by two sets of burglars. The first burglary was at an upscale home owned by a Japanese ex-pat and his Thai wife. The rear of the home is situated on a small man-made lake and there is no rear security wall. The perps arrived by wading to the rear of the home at something like 3 AM, broke into a room that is a separate wing of the home, also immediately adjacent to the lake, and stole a large flat panel TV. They literally floated it off by also stealing seat cushions from a couch located in the same room! In this instance, there was no apparent security barriers that the crooks were required to overcome and it was simply a matter of being stealthy. I do not know the eventual outcome of the case and if the goods were ever recovered.

In the other, more bizarre episodes, a perp broke in 2 or 3 homes and actually climbed in bed with a Farang's wife and attempted to rape her. The Farang apparently had a night job and was gone. The lady screamed and threw the man off of her and he fled. The same perp also broke into a nearby Thai neighbor's home and tried to rape the owner's daughter, who maintains a bedroom in a rear wing of the home. She screamed and scared him off. as well. The same perp tried it again another night, but the owner heard the break-in and fired warning shots; the fellow was able to flee. The curious part of these latter incidents was that the perp was none other than a 20-year old security guard employed by the moobaan to protect its inhabitants and their property! He had been casing various targets for months, building up a testosterone-fired need in a young man with no morals and no regard for consequences. He was later identified and caught, but I believe he was simply allowed to walk away free by the BiB, albeit no longer an employee of the security force.

We had a 'town hall' meeting of most residents after these incidents; management reluctantly agreed to setting up night-time security roadblocks at two key road intersections inside the moobaan, in addition to the already-manned main gate. We discovered that there were roughly 30 guards in employ, but that they were not unified into a single force. They were being separately managed by three different entities. The question then became: "who is watching the watchers?"

Some jittery residents have added expensive electronic surveillance systems, perimeter security/privacy walls, and perhaps their own private night-time guard. I am beginning to think that the best solution is probably a couple of dogs plus turning on a bunch of lights outside. The idea is making it unattractive to a would-be perp so he travels on to someone else's home.

The moral of this story: If you give a man a gun, you'd better watch him!

I also totally disagree with another poster's suggestion to give her money...she will take this as a sign that she can be bought and may resent it. Money in the form of meaningful gifts is far more appropriate.

Good luck!

I really really appreciate your reply. I know it's not money she's after. She is the sort of girl who is really particular about manners and appearance.

I accept that I've made a stupid mistake in going to the office. Sadly I seem to have blown my chances. I have now written her a letter and I am planning to have it delivered to her desk tomorrow. Hopefully I might be able to rescue the relationship although I'm worried I might be comitting yet another faux pas by doing so. Do you think this is a good idea?

Thanks again Fore Man.

Sambai, sorry for the delay in replying; I've been doing important things...playing golf! Since you sent your reply to my original message, there have been several well-meaning responses and a few crass ones that you can certainly ignore. I think the advice most have offered you is good--don't appear desperate and give things a chance to calm down. I also believe that after a week's time, if there has been no contact on her part, you have the option of sending a short note explaining your reasons for bringing fruit to her office....without getting too smarmy on apologies. I don't believe that an attractive (are you?) 41-year old farang is a turn-off to a modern 26-year old girl. A 15-year age difference is common here. It is how you are perceived that matters more...are you matched education and social caste-wise? Do you dress smartly? Would her family see you positively in sum or subtract points? This kind of Thai family is not going to be pleased if their daughter falls in love with a man that they believe is beneath their dignity. They aren't sure about farangs to begin with and you have to be really a 'catch' for them to support the relationship. Get in good with Mae and that's half the battle.

On the other hand, one of my friends is a 45-year old American CPA who attracted and married an educated and cosmopolitan 25-year old and they are very happy and content together. I am 16 years older than my wife. Many Thai girls don't care for the recklessness and brashness of Thai men closer to their own age and prefer a gent who has experience in life and can fully support them. Love has no age limits, and in Thailand there are differing attitudes on what constitutes love and motivations to marry.

If the lass in question fails to respond to you after that week has elapsed, and perhaps after you've sent a short note (addressed in Thai and penned by a Thai person on the outer envelope) it is time to move on. There is no need to go the BG route unless you really relish the idea...and to be frank, life is too short to miss out on all the fun. Get it well out of your system if you must. And then go to work tracking down the right lady of your dreams. They are everywhere in this society. And the next time out the chute, try to be a bit more debonair and less desperate in your approach. Women can't stand a guy who cares too much for them, too early; they also can't resist a mystery man who pushes their subliminal buttons.

Chok dee!

I've been through this a long time ago...and wound up married happily to the same gal after a 5-year courtship; but you just have to be gentle but persistent. Thai women are often counseled by well-meaning older sisters, aunts, mothers and so forth to be very wary of a farang man who demonstrates an interest in them. The conventional wisdom is that the guy will drop her and move on to a new lady. We are unfortunately notorious for being butterflies (gao chu). This causes the gal loss of face and a bad case of 'na daeng' plus perhaps a broken heart as well. Keep applying gentle pressure and reassure her that you are seeing nobody else and are willing to stick by her for as long as it takes. Apologize for showing up unannounced at her office. In her culture, doing so created a new source of tension for her by letting her coworkers and friends glimpse a new, very personal aspect of her life. It would have been far smarter to have the fruit delivered with a note from 'a secret admirer', allowing some mysticism and suspense to build for her at work. In my case, I bought a set of solid gold earrings for my lady and handed them to her privately...she wanted to refuse them but I think she secretly loved the gift and its hidden meaning that I had placed her in a special position...not someone to 'love and leave'. Take it slowly and be a gentleman. Dress nicely and always be immaculate in your grooming. She and her family and friends will place a lot in your appearance and manner (phu dee). Even a higher class Thai woman is drawn to a caring, romantic farang...in direct contrast to many Thai men who have poor reputations for how they treat their ladies.

I also totally disagree with another poster's suggestion to give her money...she will take this as a sign that she can be bought and may resent it. Money in the form of meaningful gifts is far more appropriate.

Good luck!

The Rimping Supermarkets here in Chiang Mai sell large bottles of the stuff.

Why would one want to drink this juice--does it cure or alleviate any ailments?

I had a similar problem several years ago, upon entering the U.S. at LAX and being told by the INS official to "step over there, sir, we have some problem with your identity".

It turned out that I have a fairly common name and a person with my exact name was wanted for questioning in regards to an anonymous tip for jewelry smuggling. They did a quick on-line scan and realized it couldn't be me--as the person in question was of a different race--and they apologized and sent me on my way. It never happened again. Perhaps they added a notation in my INS profile. In your own case, mistaken identity could be the culprit but I agree with another poster that you needed to summon a supervisor and find out more...as well as getting a temporary proof of citizenship letter.

If you do a good review of Dr. Google, you'll find a lot of advice on the condition. Usually, pundits recommend that sufferers avoid aspirin, salt and caffiene...which are blamed for exacerbating tinnitus. I have dealt with it for the past 19 years, following the treatment of a spinal infection which was treated with infusions of powerful antibiotics...which are also very ototoxic...and caused my initial problems with the condition. I think that stopping all coffee drinking, use of alcohol and substantially lowering your salt intake might help you lessen the severity of tinnitus. In time, you learn to live with it, although some days seem to be worse than others.

(added later): I noted an excellent summation of tinnitus by a PhD level audiologist, also a TV member. Check out his post at this thread:

http://www.thaivisa.com/forum/Tinnitus-Tre...nt-t116180.html

I concur with foregoing posters who criticize Thai practices of seeking professional help when it is often not required. But I also denigrate to a greater extent the almost total lack of concern among Thai medical professionals (those I have been treated by anyway over a 13-year period in three localities) for their head-in-the-sand mentality of treating the symptom and not the cause. How many Thais have succumbed to diseases that were 'treated' at an incipient stage, but no regard was made to the underlying cause and no guidance was given on how to prevent the escalation of the symptoms?

The Thai medical system is based on triage and treatment of symptoms...and almost no concern is expressed for prevention of disease and how other factors, such as lifestyle changes, could ameliorate a particular condition or reverse its course.

My own latest experience: I underwent my annual physical examination at a popular, Western-style hospital in Chiang Mai last week. My family care physician on the staff at that hospital, well familiar with my past four years of annual physical exam results, totally ignored a worsening creatinine level that has been rising steadily over that 4-year period. The lastest test is at the high end of the normal range, and his immediate remark when I brought this to his attention (instead of vice-versa) was "what are you worried about? It's still normal". Yes, the upper end of the normal range but next year I will probably be above normal and displaying symptoms of renal insufficiency. Their attitude is to take of problems after they happen...not to investigate them and try to impede their progress today. With no advice given by this doctor, I am seeking ways on my own to stay healthy through simple lifestyle changes that I can and certainly am adopting. In my case, I have been taking a drug that has been blamed in causing kidney problems over time, and nobody in the past 4-years took the time to explain this to me. Nobody correlated the results of my annual blood tests and realized a problem was developing. This never would have happened back in the West.

Last week, we mourned the loss of an elderly Thai man who died of throat cancer...he had experienced many years of difficulty in swallowing, severe heartburn and GERD symptoms. Without adequate imagery of his esophagus at early stages, it appears that he became afflicted with Barrett's Esophagus, a condition that it almost always a precursor of esophageal cancer. And sure enough, this suffering gentleman died a miserable and painful death from cancer when it could have been headed off long before it became acute. Whenever he visited the hospital, I was told that he was treated with acid reflux medications but little else by way of diagnostic tests were completed. Ergo, the pills helped him to alleviate the symptoms but the disease process continued unchecked until it was too late to save him. This was no poor rural chap--he was a high wage earner and a professional who went to the best hospitals available to him...all for naught.

I believe that Thai doctors have a long, long way to go in adopting and applying preventive medicine procedures for their patients. There seems to be an acceptance among the Thai people--medical professionals and lay people alike--that premature loss of life due to disease is both predictable and unpreventable. What a terrible shame.

I apologize to those Thai physicians and caregivers who do their best to prevent disease among their patients, counseling them on lifestyle changes and other means to stop the onslaught of medical problems, but would like them to understand that this is my own personal opinion based on years of observation and experience.

None that I know of...a Schengen visa ( http://www.axa-schengen.com/english/schengen-countries.html)

will be necessary for visits to Schengen countries. Others require their own visa (such as the UK).