PPMMUU

Dying at home is often preferred by most patients, if asked. There are several options for managing pain at home for end-of-life cancer patients, including the use of oral morphine for those who can swallow pills. Patients who are unable to take pills can receive continuous subcutaneous infusion of morphine and other medications. This approach is gradually becoming a standard practice in Thai government hospitals, although the progress is not as rapid as desired. I wish the best for the OP and the patients.

35 minutes ago, sapson said:

Thankyou!

You are a westerner i presume or Thai with excellent English skills, out of interest whats your position in the government hospital?

I'm a Thai doctor with a somewhat passable English skills, with a little help from ChatGPT for grammar corrections.

To me, Suphan Buri is hardly the middle of nowhere. There is a Robinson department store and a multiplex cinema with a soundtrack option, although they may have fewer features. What kind of activities are you looking for? Perhaps they can be found there. I can find several gyms with a simple Google search. You might want to try again with the keywords 'fitness' or 'ฟิตเนส' because that's what Thais call a gym.

There are some, but not every, public hospitals that offer newer standards of hernia repair. You can visit and discuss with them to see if they have such options available. The 300k laparoscopic option isn't going anywhere anytime soon.

1 hour ago, sapson said:

Thanks for your response did indeed have the NT pro bnp today it was rather expensive 1300 baht maybe bought some peace of mind,,,not sure, the result was 150 pg/ml with their normal being 0-125 pg/ml so high by their lab parameters but doc said totally normal.

 

Doctor Google says anything over 125 pg/ml huge increase in cardiac event risk........whos telling it as it is? a young Thai cardiologist or professor google???

 

Seeing a UK doc older and with more grey hair than me and with a wealth of experience is one good thing about the UK and no language barrier although near impossible to see a doc unless near death,,,,,

 

Do you work in a government hospital here or the Uk or elsewhere?

The doctor's statement about the "normal" level of NT-proBNP likely refers to its role as a marker for determining the presence of chronic AF or chronic heart failure. If I remember correctly, the cutoff for distinguishing between these conditions is much higher than just above the normal range, possibly around 300-500.

Regarding determining normal or abnormal levels for specific conditions in specific patient groups, several international committees review the evidence and develop guidelines distributed to doctors. This process is carried out for virtually every disease.

There is a saying that is difficult to argue against, which states that the best doctor is the one you get to see.

I work in a government hospital in Thailand.

Wish you good health!

I'd say that NT-proBNP is a very useful blood test to determine heart insufficiency. The price is out of my knowledge since I work in a government hospital, and patients don't have to pay.

If AFIB still persists, you will need regular checkups with a cardiologist or internal medicine doctor, or at least a doctor for months if not years. So, the choice of drug can be discussed with the doctor. I strongly advise against buying drugs over the counter, even if they are available over the counter in Thailand.

It seems you are leaving for the UK. I would suggest that you obtain a summary of your medical history from the doctor who performed the workup or another doctor at the same hospital. That would be very useful for further cardiac workup in the UK.

On 6/11/2023 at 8:56 PM, Felt 35 said:

Ugh, don't scare the crap out of me. However, I understand the depth of the message.

Next scheduled appointment with current doctor is Tuesday (unfortunately far from a specialist on infection diseases) then I have been on antibiotics 7 days which as I understand is the norm with this disease before eventually further treatment! 

Thanks

Felt

 

tuesday schedule is good enough. that's fortunate indeed. wish you good health!

Cellulitis on the face is a serious condition. If you can schedule an appointment within 1-2 days with your preferred doctor, that's acceptable. However, if that's not possible, it's crucial to see any available doctor as soon as possible—preferably today—to address the situation promptly.

I recently came across an interesting article on a news website about Koon Hospital, a specialized facility dedicated to palliative care. If you're interested, you can find more information about it on their official website: https://www.koonhospital.com/.

22 hours ago, jts-khorat said:

@PPMMUU was it?

The text was indeed written with the help of ChatGPT, but solely to transform my thoughts into coherent and understandable language. All ideas and points expressed in that text are completely mine. I apologize for any shortcomings in my English proficiency.

The mentioned elevation in liver enzymes is very mild and could indicate a range of possibilities. However, it is highly likely that it is nothing to be overly concerned about.

There are various possibilities regarding the results of a blood test for hepatitis B:

1. Despite being vaccinated, it is possible for a blood test to indicate a past hepatitis B infection.

2. A blood test can show that you have been vaccinated with the hepatitis B vaccine and have not been infected.

3. It is possible to have been infected with hepatitis B for a prolonged period, resulting in chronic infection and some degree of hepatitis. Such a condition can be detected through a blood test.

4. It is also possible to have been infected with hepatitis B for an extended period without experiencing hepatitis symptoms. In such cases, you may be a carrier, and this can be identified in a blood test.

5. Additionally, it is possible to have immunity to hepatitis B but still have hepatitis due to an entirely unrelated cause.

Losaar Plus combines losartan and hydrochlorothiazide in a single pill. Both losartan and hydrochlorothiazide are commonly available and sold over the counter in Thailand, although they may not be found together in the same pill for your convenience.

On 4/6/2023 at 8:25 PM, kokesaat said:

Thanks for the info. I've been an amateur Thai learner for 15 years......can read/write/type/speak passably, and can't say I've come across the character (ฤ)ๅ.  I never learned the alphabet (a,b,c,d), so maybe that's where I missed out.  Thanks, again.

Interestingly, ฤ, ฤๅ, ฦ, and ฦๅ are commonly categorized as vowels, not alphabets. Don't ask me why.

Correct me if I'm wrong, but I'm feeling confused. So, do they find nothing or do they find that it is an amoeba infection? It can't be both, right?

1 hour ago, h90 said:

and now without control do you see the dead people from a cannabis overdose on the sidewalk? No....It was a hype on the beginning now it is kind of boring and no major problems. Sure less problems than beer causes.

It's a major problem. People who have serious effects from using cannabis are going to hospitals and using up healthcare resources. Some may argue whether or not this puts a heavy burden on healthcare, but saying it's not a major problem is just not true.

Alcohol consumption is a very very big problem. Merely stating that something causes fewer issues than beer does not hold much weight.

Personally, I am somewhat okay with recreational cannabis as long as there is some form of control. However, the current situation lacks any control whatsoever. If the reclassification of cannabis as an addictive substance means that there will be some control, I can support that.

Although people who do not get vaccinated are a minority in society, they make up the majority of COVID-19 deaths. This show that vaccines help to protect people from getting sick and dying from the virus.

Bell's palsy was very common even before COVID-19. It is still as common now as it was before, not more common.

Experiencing a cough that persists for six weeks is indeed a significant duration. It would be wise to consider visiting a doctor for further evaluation. In the meantime, you could try using an antihistamine to see if it provides relief. If your cough shows noticeable improvement within a few days, it might not be a cause for major concern. 

It seems that you have visited the private section of Chulalongkorn Hospital. There is no doctor fee in the public hospital system of Thailand.

Generally, the test for the BRCA2 mutation involves taking a blood sample from you, which is a simple process that involves using a needle and syringe and can be done almost anywhere. The blood is then sent for testing, which is a complex procedure that can only be done in a few places. From my understanding, most well-known private hospitals offer this test, which typically takes a few weeks for the results to come in, and the cost can be in the tens of thousands of baht.

Although free cancer care in Thailand is not perfect, it is still quite decent. To compare it to Western standards from 50 years ago would be a severe exaggeration.

I shouldn't be. But, yes, it is.

Uterine fibroids are a common condition that may not always require treatment, and certainly not always surgery. However, there are cases where treatment may be necessary.

In Thailand, virtually any obstetrician-gynecologist is capable of performing a hysterectomy. Therefore, the decision of where to have the procedure done is not a difficult one. The more important consideration is whether or not the surgery is necessary for your wife.

When discussing this issue with other Thai doctors, it may be helpful to use the term "myoma" or "myoma in uterus" instead of "fibroid." This terminology is more commonly used in Thailand and may facilitate better understanding among medical professionals.

In Bangkok, there is a dedicated government hospital for cancer patients known as the National Cancer Institute. It is conveniently situated adjacent to Ramathibodi Hospital and in close proximity to Victory Monument.

Besides this facility, there are several other excellent options for government hospitals that specialize in cancer treatment in Bangkok, including renowned university teaching hospitals such as Chulalongkorn, Ramathibodi, Siriraj, Vajira, and more, as recommended by many others.