Dirk Z

Dizziness is one of the least specific complaints. It can mean anything or nothing. If it persists and you worry, go see a doctor and avoid the experts here.

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.

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.

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.

A radiographer (technician) makes the images and the radiologist asseses them.

Easily done online with quick response. Cost about 280 baht.

Still a medication....

We live in a Buddhist country, but you wouldn't believe it if you see all the Christmas items around you: shop assistants and waiters with Christmas hats, Christmas trees, decoration etc. and last but not least the endless Christmas music in restaurants, shopping malls, public transport, resorts, virtually everywhere. Thai seem to think we like it or maybe they like it themselves. My question is: who enjoys the omnipresent Christmas music, both the traditional and the Christmas hits? Or on the other hand: who is relieved or maybe even sad when it's all over again?

After marrying I never bothered to change my single person visa fearing that I would need to provide more paperwork. There is indeed the requirement of less money in the bank, but I just left my 800.000 where it had already been for some years.

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?

I arrived as an atheist and have remained as such. Unfortunately, in spite of what they will want you to believe we are no more than molecules and cells and when the cells die - game over.

There is no support for this remark.

Defense is correct, but members of the EU are supposed to support one another and a country in war is a different ballgame.

Hungary sort of abstained, so Ukraine will start talks. But it can never join as long as there is a war going on, everybody is clear about that.

Exactly the same happened to me. I found out on Friday 3 November about lack of pages, had an appointment at CW on 16 November for renewal of visa (expiring 30 November). I sent my Embassy (NL) an email. Normal appointment would be at least two weeks later, but they said I could come that Monday 6th. I got my passport with an express service on Friday 10th, well in time. To my surprise the express handling cost only 10 euros and the business size cost nothing extra. You should get in touch with your embassy and tell them you need a passport urgently. I think it happens all the time, e.g. when it gets stolen or lost. I am surprised that people recommend traveling to the UK for a new passports. I think all embassies handle these things, that is what they are there for!

I have been going to Pornsak Dental Clinic on Sukhumvit soi 49 for more than 15 years. Extremely happy, had all sorts of stuff done. He explains everything, always tries to preserve and reconstruct before offering expensive options and has very soft hands. Price more than reasonable, even had small jobs done for free.

Covid is here to stay but is mostly hardly more serious than influenza. It looks like there is a need to scare people again, since a scared population is easiest to control.

Google wallet works with BKK Bank credit card.

I received an e-mail from VISA notifying me of fraudulent use of my credit card before I even noticed it myself. They blocked the card, will send a new one and reimburse the fraud. In the app I saw it was € 80 of Uber rides in Dubai (where I had not been). Great service. Booking.com controls many online services: Agoda, Hotels.com, Rentalcars and maybe more. I think it is impossible to find a 100% safe service, but it looks like the credit card companies are alert and you always have to be alert yourself when you get e-mails about financial issues.

Thank you for your understanding. Much appreciated. But I was not only talking for myself but for many colleagues I know.

Maybe I am a bit sensitive about this. In my professional life I have had to do with terminal patients and voluntary death. I remember it as a very sensitive and emotional procedure for all concerned. But in my opinion it does involve a careful deliberation of the patient him/herself and a free choice. Putting an animal out of its misery comes nowhere near. But if, as some seem to do, you just mean a kind way of causing death then OK, but as I said it has very different implications for me and I cannot use the term without that.

That is correct, the killing of a patient. But it's not done just like that but covered with an extensive and careful procedure. And it always requires the wish and consent of the patient. That is just my point.

Let us please not use the word euthanasia here. Euthanasia is a specified process with a written letter of intention, a second opinion etc. It is called putting down, ending life, whatever, put also not "putting to sleep" if waking up is not the intended outcome.

The panel has 80.000 members and therefore 80.000 potential votes. In reality only a small number actually votes. And the panel consists of self-applied voters, those interested enough to participate and having some online skills. The group is not representative of the population as a whole.

Please don't spread fake news. The numbers for criminal offenses have gone down over the past ten years: 2013 1.105.565 2014 1.025.630 2015 978.945 2016 930.325 2017 832.950 2018 786.420 2019 821.905 2020 813.150 2021* 757.795 2022* 806.210 (source: https://www.cbs.nl/nl-nl/cijfers/detail/83723NED)