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Dirk Z

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Posts posted by Dirk Z

  1. 16 hours ago, retarius said:

    Hope it works. It would be nice to have a decent taxi service. Tuk-tuks are vile and dirty and should be scrapped immediately. They are not in any way picturesque, they are simply uncomnfoprtalber dangerous and smelly driven by mad men.

    Raise the fares in regular air-conditioned taxis, taxi drivers deserve a fairer deal for doing a tough job, but jail any driver who doesn't use a meter or has tampered with it. What I would like to see is the meter wired into the ignition, so that if the meter isn't running the ignition doesn't work, (but of course you would also need sensors in all the seats to ensure there were no passengers, and then the ignition would work without the meter. 

    Agree on all qualifications, but you forgot loud, too loud, unnecessary loud.

  2. 20 hours ago, superal said:

    I do not think anyone is claiming to be an expert on this post , the exception being Sheryl . Members like to chat and exchange their experiences with folks who have had  similar medical conditions . 

    Of course , getting an appointment with a decent Thai doctor ( if in Thailand ) is the answer and nobody on this forum is suggesting otherwise . 

    You may have missed the irony in my post. But even though it is often just an exchange of ideas and experiences there are certainly posts that strongly suggest a certain course to be taken, and that was what I was referring to.

  3. In a previous post I said: "I have a record of only 121 patients treated for hydrocephalus over a period of 30 years and this includes all forms." I omitted : patients over 65 years of age. The many other CSF operations are children or younger patients where it is unlikely that they had NPH. Even those over 65 are not allNPH patients, but my database records treatment and not diagnosis.

  4. On 1/6/2024 at 1:18 PM, Sheryl said:

    I see. Normal pressure hydrocehalus (NPH) is a very common funding in  people over age 60 and can sometimes cause tremor and other Parkinson-like symptoms, However  "fluid increases to the limit acceptable for my age" suggests you do nto, at this point, meet the definition of hydrocephalus (which would be fluid amount over the normal limit for your age) hence the advice to just repeat the MRI in a year.  I don't think any one is going to perform surgery for hydrocephalus with your current findings and symptoms.

     

    However, the MRI finding does not seem to explain your tremor (assuming the radiologist's report is accurate - should certainly have the actual scan re-read by a skilled specialist)

     

    A  neurologist with expertise in hydrocephalus (even though you seem to fall short of that diagnosis) at Siriraj is   Prof. Sarun Nunta-aree

    https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=239&medical_id=59&day=&startTime=&endTime=

     

    He can also be seen at Bangkok Hospital  https://www.bangkokhospital.com/en/doctor/dr-sarun-nunta-aree-2

    You will nto get a different result at a different hospital seeing the same doctor. But SIPH maybe be a bit less costly than Bangkok Hospital.

     

    Be sure to bring the actual DVD of the MRI with you, not just the report.

     

    If the result of this consultation is that your MRI findings do not explain your symptoms (quite possible), you could  then consult specialists  in MS and Parkisnon's, as tremor can be early sign of both. There are many MS specialists at Siriraj, ask Prof. Sarun to suggest one. For Parkisons's  that seems to be more a Chukalonhgkorn specialty  while Siriraj's neuro department ism ore focused on autoimmune neuro problems like MS.  If you want to see a neurologist at Chula let me know.

     

    Wherever you go, you should have some basic tests to rule out non-neurological causes of tremor such as:

    - B12 level

    - serum sodium, calcium, magnesium

    - HB1Ac (for diabetes/hypoglycemia)

    - thyroid panel

     

    The light-headness after getting off elevator at a high floor is actually more suggestive of an inner ear issue than anything else. Do you have vertigo at any other times, like when rapidly getting out of bed or otherwise changing position?

     

    Lastly:

    - how much do you drink? (alcohol)

    - What if any medications are you on?


     


     

    Sorry to have to correct you. NPH is not common at all, ventriculomegaly is, but it is not the same and not treatable as opposed to NPH that can have good results after shunting. The triad of symptoms for NPH are cognitive deterioration, gait disturbance and incontinence. On the MRI large ventricles with hyperdense lining. Tremor and Parkinson symptoms are not part of the NPH complex.

  5. Please allow me to clarify some issues about hydrocephalus. In the brain there are four spaces filled with cerebral spinal fluid, the brainwater. We call these the ventricles. In the course of life we all lose brain matter. In some this is more than in others. The space lost by the brain tissue is filled with the cerebral spinal fluid. So the ventricles become larger. They can also become larger when the outflow of the cerebral spinal fluid is obstructed. If this is complete, for instance by a tumour, it leads to serious symptoms that need emergency treatment. If it proceeds slowly then the symptoms will be more gradual. This can be the case in the so-called non-resorptive hydrocephalus where there circulation of the cerebral spinal fluid is disturbed because the fluid is not taken back by the circulation system. This causes the syndrome of normal pressure hydrocephalus (NPH). Unlike Sheryl says in her comment this is not a common condition. I have a record of only 121 patients treated for hydrocephalus over a period of 30 years and this includes all forms. Only a part of these were probably normal pressure hydrocephalus. The diagnosis is not always easy to make. There are symptoms that point in the direction like cognitive deterioration, problems when walking or incontinence with an enlarged ventricle system on the MRI. But even that is no proof and does not guarantee a good result of a treatment which consists of a diversion of the cerebral spinal fluid to the heart or the abdominal cavity. There are some additional tests but none of them is 100% conclusive. The MRI can show some typical signs but even then no guarantee for correct diagnosis.

  6. 1 hour ago, bigt3116 said:

     

    the British embassy does not "handle these things", and that is not what "they are there for!"

    It is my understanding that one of the obligations of any embassy is to take care of their citizens in places outside of the mother country. I therefore found it no more than obvious that replacement of a passport in a case where is some kind of urgency is one of the things they should handle. But if that is not "what they are there for" then enlighten me, what is?

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