crouchpeter

On 9/19/2022 at 7:42 AM, scubascuba3 said:

Just another example of bill padding, like the mandatory blood pressure and temperature checks

You don't get into any hospital without having BP, weight and temperature taken. It's sooo logical!

On 9/27/2022 at 4:49 PM, eiszele2005 said:

I have a Tp link 4G router up country, signals here are ok at best but the router has never missed a beat and 4G is our only option for service. I stream all day long on an unlimited Dtac 30Mbs for 12 month card for about 1600 Baht a year(search Lazada) you do need a new one each year as can not just top up online and continue the service but easy enough. 

In short it works fine for normal user. 

Exactly what I use, (except AIS), 4 Mbps and 30 gb/ month. Last year was 1100 baht, but now about 1600 baht per year. Went to AIS to recharge last week, and from now on can recharge online. And I watch Netflix, YouTube etc. + computer, phone.

Is your jaw clicking?

On 3/10/2022 at 12:42 PM, Sheryl said:

 

There is always an injection to block nerves immediately before a cataract operation, unless it is done under general anesthesia (which is rare).

 

The injection is done in the OR itself so people may not think to mention it.

He said he had local in his cheek, so I'm wondering what block that was to anaesthetise the eye. That nerve, the sub-orbital, blocks the maxilla from 1 to 3 only.?

On 9/24/2022 at 2:20 PM, Lacessit said:

I'd rather chew razor blades than live in Bangkok, too many people.

 

I'm not sure where Rooster gets his data on smoke pollution in Chiang Mai, the API hasn't got over 50 this year thanks to unending rain since Songkhran. Perhaps he is addicted to the more civilized diesel fumes of Bangkok.

 

Be of good cheer, fellow country bumpkins. Those rains are heading for Bangkok, giving Rooster something else to bitch about when he has to park his car on an overpass.

 

 

What car? They cost money!

4 hours ago, Denim said:

Less than that even.

An old Thai woman is feeding a stray and gets savaged by her pit bull. And you say "no sympathy"! I think that says a lot about your lack of humanity. Unbelievable.

On 9/11/2022 at 5:22 PM, Freed1948 said:

I must be 'the odd one out'

You mean the only one who isn't a sycophant. I worked in England for 15 years in the 70's+, and we weren't respected at all. Just "Colonials"! But we were a source of cannon fodder and raw materials until those two-faced aristocrats ditched us, (and NZ), for their new European common market friends. And now we'll be crawling to a new buffoon!

On 9/4/2022 at 2:50 PM, JackGats said:

If I remember right it is best to have implants soon after extraction, otherwise the jaw bone at the extraction spot retracts and eventually there isn't sufficient bone to anchor the implant. I guess a simple x-ray can tell whether an implant stands a chance. 

 

I'm going to need to get root canal tooth 48 (lower right last molar) extracted in the coming months. I'll go for an implant. There's probably no other choice as it is the last tooth (not counting a wisdom tooth now long gone). I already have an implant on tooth 47 next to it, but the crown on that implant broke into pieces two months ago. Replacing that crown will set me back 35k Baht according to Dentist@Beach in Pattaya. That is nearly the cost of a full implantation procedure. It is a Straumann implant (expensive manufacturer!). I assume crown breakages on implants are rare and I was just unlucky.

48 is the lower wisdom tooth, unless you're an aborigine. A new crown on the implant should be normal cost....12,000 baht.

10 minutes ago, crouchpeter said:

30 baht card doesn't cover accidents. But most schoolchildren have insurance covered by the school. And 18,000 isn't expensive., depending on the op. and staying in hospital.

EDIT. Looks like the 3rd party insurance here covers the driver in a single vehicle accident, whether the driver is licensed or not. (Por Bor). Don't know about registration criteria.

On 9/12/2022 at 3:42 PM, EricTh said:

 

Do Thai people pay the same rate as foreigners in a public government hospital? 

 

Depends on which hospital.

On 9/12/2022 at 1:20 PM, Luckyman999 said:

I agree .. but how can I prove? Anyone here in the forum has experience?

 

 

Yes .... I asked also for the bill ... item pending ....

30 baht card doesn't cover accidents. But most schoolchildren have insurance covered by the school. And 18,000 isn't expensive., depending on the op. and staying in hospital.

50 minutes ago, xylophone said:

Jesus, if you were on the Oxford or Cambridge debating team, then it must have been a pretty poor bunch!

 

First of all I stated that I had Streptococcus sanguinius in my urinary system and that was confirmed by a culture test, yet you dismissed that as not being the case???

 

I also presented case histories/medical publications of the same and also regarding this particular bacteria being found in the prostate, again you dismissed it, obviously because you didn't read them, and my point about this particular bacteria was that if it gets into the bloodstream it can be dangerous, which you have now stated can be the case.

 

And as for your assertion that the dentist I had which fractured my lower jaw was a "poor operator" then that's another own goal for you, because my normal and highly regarded dentist in New Zealand recommended a well-known oral surgeon to do the extraction because the root of the tooth was somewhat crooked in the jaw, and it was he who fractured my jaw.

 

And just for the record no, I wasn't stressed or run down or immunocompromised when the Streptococcus sanguinis found its way into my urinary system.

 

As for your last question regarding advocating antibiotics for all dental patients, that is not something I've advocated, and I will go with what the experts know (not you of course) and what is widely recommended by these experts.
 

A lot of misquoting here. Most prostatitis infections are E. Coli for obvious reasons. All bacteremias are potentially dangerous, but usually the body deals with it. But sometimes with diabetics, old people, generally unhealthy, fat, smokers etc. it can't. And then we have acute prostatitis, cellulitis, fasciitis. But you're becoming blinkered in your one man battle against Streptococci. Perhaps listen to the doctors instead of rubbish talking about your "in depth research". You've diverted the subject from antibiotics after extraction, incidentally telling me I don't know what I'm talking about, to your prostatitis involving flora that is found in the oral cavity as well as in every other orifice in the body. And after all this pseudo intellectualism, you've probably never even examined a patient in your life!

15 minutes ago, xylophone said:

Yes, and I have offered my expertise and research on streptococcus sanguinis, which has been found in the prostate, and indeed in my UTI.

 

We may differ on this, but I've been through this actual experience and there are medical journals which backup my research.

 

No doubt about it you are the expert on dentistry, and although your posts would suggest that antibiotics are not necessary, again there are many, many medical articles which are in favour of issuing antibiotics, and many which warn of the problems with streptococcus sanguinis finding its way into the bloodstream and colonising the heart valves (which you scoffed at in one of my earlier posts) especially in cases of difficult extractions (wisdom teeth?). 

 

So I guess we will have to agree to differ. However if you are unfortunate enough to get that particular bacteria in your urinary system/prostate, then you may be in for many years or even decades of prostatitis, which is extremely unpleasant.
 

PS. I hope the checkup and x-rays on your hip replacement show that everything is well.

Any invasive dental procedure forces bacteria into the bloodstream, even a scaling. So you're advocating Ab cover for all dental patients?

7 minutes ago, xylophone said:

Yes, and I have offered my expertise and research on streptococcus sanguinis, which has been found in the prostate, and indeed in my UTI.

 

We may differ on this, but I've been through this actual experience and there are medical journals which backup my research.

 

No doubt about it you are the expert on dentistry, and although your posts would suggest that antibiotics are not necessary, again there are many, many medical articles which are in favour of issuing antibiotics, and many which warn of the problems with streptococcus sanguinis finding its way into the bloodstream and colonising the heart valves (which you scoffed at in one of my earlier posts) especially in cases of difficult extractions (wisdom teeth?). 

 

So I guess we will have to agree to differ. However if you are unfortunate enough to get that particular bacteria in your urinary system/prostate, then you may be in for many years or even decades of prostatitis, which is extremely unpleasant.
 

PS. I hope the checkup and x-rays on your hip replacement show that everything is well.

Like you, I've done oodles of research on hip replacement surgery. The best implant, the best approach, the best anaesthetic, the surgeon's expertise etc. etc. There's nothing I don't know about revision, failure rates and causes, rehabilitation etc. And guess what, even with my oral surgery experience,..... I still couldn't do one! And that's the bottom line.

2 hours ago, xylophone said:

With respect you seem to be missing the salient point in a couple of the links/research I have posted, whereby streptococcus sanguinis has been found in the prostate, and can be the cause of prostatitis – – and for anyone who has had this condition, that would indeed be a "salient point". So these bacteria DO NOT ONLY CAUSE PROBLEMS WITH COMPROMISED HEART VALVES!!!!!

 

It's all there, out in the open in published and peer-reviewed papers/research if you care to look

The oral bacteria have nothing to do with the bacteria at the other end of the body under normal circumstances. If you've got inflammation of the prostate, (not infection), or UTI this is due to being stressed or run down or immuno-compromised or bad luck. And we're talking about oral prophylaxis; nothing to do with infections in other parts of the body. It's very frustrating arguing with people who weren't on the Oxford or Cambridge debating team! They can never stick to the point so as to try and prove they weren't wrong. As an aside, if your dentist took an hour to extract your lower 8, and fractured the mandible, I don't think he's an oral surgeon. Just another operator biting off more than he can chew; like we all do sometimes.

2 hours ago, owl sees all said:

Amoxicillin supposedly stops bacteria getting to the heart, where it 'could' cause problems.

 

Why have four out in one sitting? Too traumatic! If you had pulled them yourself one at a time - with a gap of two weeks between - it would have been much kinder to the mouth and your body in general.

Because you only suffer once!

11 minutes ago, retiree said:

My impressions are that a) infection is usually an issue for the lower wisdom tooth extraction, but b) delayed infection is far more common for these, and c) prophylactic antibiotics immediately following extraction aren't much help for delayed infection (it's more about patient's dental anatomy predisposing development of a problem).  So, the proper course of action (like watchful waiting, maybe?) would rely on the dentist's judgment.   

 

Can crouchpeter (or any other lurking dentists) shed some light on this?  

 

-- Retiree 

OK. I've just offered my expertise to "Xylophone", and as I'm being driven to Bangkok to have check up and x-rays after a hip replacement 2 and a half weeks ago, this stops me being bored! Firstly I've done thousands of lower wisdom teeth removals, usually impacted, and probably at least 100,000 other extractions. Post op any extracted tooth socket can get infected, and the stats are approximately 20%. However, for lower 8's the percentage is closer to 100%, especially if they are impacted and a flap is raised and bone removed. So when you see your wisdom tooth patient a few days to a week later,they look like a squirrel that has stored his nuts in his cheek pouches! They can't open their mouth, can't sleep, they stink and they hate you. The only treatment is hot and cold packs, NSAIDS and gentle rinsing. Now to the nitty-gritty. These infections are called,"dry sockets", because the blood clot breaks down and bleeds out 48 hours after the extraction, leaving bare bone,. Always painful. The treatment is to gently clean out the socket, try to make it bleed, and pack it with Alvogyl. This works in 20 minutes, but not as well for lower 8s. The point is, antibiotics cannot get to the source of the infection. They do not work! Sometimes you'll extract a tooth and the pus will pour out. Again, no Ab necessary. Of course if afterwards the submandibular gland is swollen, then give Amoxicillin for 7 days. But that's rare.

.

56 minutes ago, xylophone said:

The quotes I used were from carefully controlled studies and not just any old "quotes from Google", and furthermore there is more information available on it, the deeper you wish to look; and I have been doing this research for decades now, and I have enough information and links in this research to prove my point.

I don't follow the media and "shallow social media blogs" when doing my research on prostatitis, but I do follow published papers and peer reviewed studies.

 

I'm not doubting your qualifications, however I am saying that you are mistaken on this particular point and my next point below further backs this up.

 

Again, further research will show that streptococcus sanguinis has been found in the prostate and in my case it was found in the urinary tract, which was verified by culture tests done at Bangkok Phuket Hospital.

 

The article below will explain this and hopefully put paid to any doubts you may have about this particular bacteria...........

 

According to the classification criteria established by the U.S. National Institutes of Health (NIH), prostatitis is divided into the following four categories: acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and asymptomatic prostatitis. CP/CPPS reportedly has a significant negative impact on the quality of life.1, 2 CP/CPPS accounts for 80% to 90% of prostatitis cases,3 but its etiology and pathogenesis remain poorly understood.

The pathogens isolated from global cases of acute and CP primarily include Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella, Proteus spp., Enterococcus spp., Pseudomonas aeruginosa, and Corynebacterium.4, 5 Chronic bacterial prostatitis may also be caused by anaerobic bacteria, the most common of which are Streptococcus sanguis and Bacteroides. Studies have also shown that sexually transmitted microorganisms, such as mycoplasma, Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus, and Trichomonas vaginalis, are among the most common pathogens of CP.3, 6

https://onlinelibrary.wiley.com/doi/full/10.1002/pros.23971
 

AND from another publtshed article:  Blood and urine cultures resulted positive for S. sanguinis. In this case, we report S. sanguinis causing urinary sepsis as a primary inciting event. Although S. sanguinis is an unusual cause of urinary tract pathology, treatment should be considered if the clinical picture is consistent with infection. Given the concern of dissemination, we recommend at least two weeks of antibiotics against S. sanguinis with repeated negative blood cultures prior to ureteral procedures.

 

For the record, my son is a medical professional in London and specialises in infectious diseases, and has published many papers. Perhaps the need to gain knowledge in this area is genetic!!!!!!!

The glaring mistake I perceive is that these articles and/or you, fail to address the main and salient point, which is that these bacteria only cause problems with compromised heart valves. The correct protocol here can almost be a life or death situation. As an aside, if you'd like me to explain why antibiotics are useless after extractions, you only have to ask.

5 minutes ago, crouchpeter said:

The trouble is, everybody uses quotes from Google without having any in-depth understanding of the various and complicated mechanisms related to the workings of the human body. It's not black and white! Two properly conducted studies can come up with 2 different end results; and they're both right. This is because of biological subtleties and different interpretations. So contrary to what the media and shallow social media blogs tell you, there is no magic bullet; just boring protocols to hopefully get a positive result. And of course, the waters are muddied further by ignorant idiots such as King Charles III, who is a laughingstock to British doctors!

Just an edit. Strep. are also found in the bowel, urinary tract, vagina etc. , so its unlikely oral bacteria would infect the urinary tract.

17 hours ago, xylophone said:

Well I was only quoting from published papers and from Wikipedia, and what I have also been told by a dentist friend of mine, and much to my dismay this particular bacteria found its way into my urinary system (it was cultured so was definitely this bacteria) and I had to have 14 days of intravenous carbapenem to get rid of it, which was extremely expensive. See below...................

 

Streptococcus sanguinis (S. sanguinis) is an abundant oral commensal which can cause disseminated human infection if it gains access to the bloodstream. The most important among these diseases is infective endocarditis (IE).

https://www.frontiersin.org/articles/10.3389/fmicb.2020.00010/full

 

S. sanguinis is a normal inhabitant of the healthy human mouth where it is particularly found in dental plaque, where it modifies the environment to make it less hospitable for other strains of Streptococcus that cause cavities, such as Streptococcus mutans.

 

S. sanguinis may gain entrance to the bloodstream when opportunity presents (dental cleanings and surgeries) and colonize the heart valves, particularly the mitral and aortic valves, where it is the most common cause of subacute bacterial endocarditis.

 https://en.wikipedia.org/wiki/Streptococcus_sanguinis

The trouble is, everybody uses quotes from Google without having any in-depth understanding of the various and complicated mechanisms related to the workings of the human body. It's not black and white! Two properly conducted studies can come up with 2 different end results; and they're both right. This is because of biological subtleties and different interpretations. So contrary to what the media and shallow social media blogs tell you, there is no magic bullet; just boring protocols to hopefully get a positive result. And of course, the waters are muddied further by ignorant idiots such as King Charles III, who is a laughingstock to British doctors!

On 9/12/2022 at 11:26 PM, xylophone said:

You may wish to stop your "mind boggling" and do some research...........

 

S. sanguinis may gain entrance to the bloodstream when opportunity presents (dental cleanings and surgeries) and colonize the heart valves, particularly the mitral and aortic valves, where it is the most common cause of subacute bacterial endocarditis. For this reason, oral surgeons often prescribe a short course of antibiotics to be taken a few days before to a few days after oral surgery. Once an infection has occurred, treatment is much more complicated and generally involves the administration of several weeks of penicillin and aminoglycoside antibiotics.

 

First of all; I'm a dentist. It's strep. viridans found in the mouth, and it can compromise damaged or artificial heart valves only! The bacteria do this by settling behind the flap of the damaged valve, where blood flow is hindered and form a colony. Similar to the little atrial appendage in the heart during AF where blood clots hide sometimes. So 1 hour before invasive dental work you take 3 gms. Amoycillin. This also applies to any prosthesis for 3 months after the op. Eg. Hip replacement. Of course, I've been retired for 7 years now, so might have forgotten some of the big words used to impress!

On 9/10/2022 at 1:11 PM, xylophone said:

Yes, you are quite right, having four wisdom teeth extracted at one go is not trivial and as you suggest, I believe he should take the antibiotics.

 

A dentist friend of mine in NZ gave me antibiotics at the same time as removing a very difficult and deep-rooted wisdom tooth, and this took over an hour!

 

Unfortunately there are quite a few bacteria that live in the mouth and one which is usually protective of teeth and environs, Streptococcus sanguinus, can be dangerous if it gets into the bloodstream, causing problems with heart valves.

 

No harm in taking the antibiotics if prescribed.
 

The mind boggles reading these fairytales!

On 9/5/2022 at 9:51 AM, Bangkok Barry said:

A friend of mine died in Phuket and within hours the locals descended like vultures and his house was stripped of everything, including the bed he died on, and his SUV 'vanished'. Morally bankrupt people in the land where money trumps all.

No different in Australia when the "inheritance" involves ex-wife, girlfriend, children, step-children, favored friends, nieces and nephews. And this stripping of the house and fighting over money usually happens while they're in hospital, still alive.

3 hours ago, rickudon said:

British University education Has become a disaster since you have to pay for it. In the 60's and 70's, you got free tuition and modest grants towards living costs. About 10% went to university and many would quickly get a job afterwards with some relevance to their degree. By your late 20's you were buying a house and thinking of having a family.

 

Now, 50% go to university, many to pretty useless courses. By the time you finish you have 60,000 GBP of debt at interest rates of up to 6%, most are still paying it off in their 40's - latest estimates are that nearly half will still be paying it off in their 50's, if ever. These debts and crippling house prices mean many will never buy their own homes, and marriage and having a family is out of the question without 2 incomes. Few graduates get a job related to their degree - and most now need to do a masters course (more debt) to stand out from the crowd. Getting a graduate level job can take years, and you earn less than those who left school at 18 and went straight into skilled work. Typically you have to apply for hundreds of jobs to get one.

 

As nurses and those who previously did apprenticeships were encouraged/forced to go to University, there is a lack of skilled manual workers (electricians, plumbers, carpenters etc.) so they now earn more than graduates. The universities themselves have become commercialised - it is all about getting the tuition fees in and spending that money - and because the students pay, you cannot fail them anymore easily, or they sue. International students especially prized as you charge more.

Only people who positively financially benefit from University are doctors and lawyers.

 

University education should be rationed to a countries needs and to those with sufficient academic ability, for most people apprenticeships, on the job training and specific courses for specific skills are more useful - and the employers KNOW what they need.

 

The whole world is overflowing with university graduates for whom there are no jobs.

And dentists.

On 8/30/2022 at 10:17 AM, Peterw42 said:

If they where born here they are not Chinese, They are Thai

Amazing logic!