dblaisde

Followup: I seem to be doing much better now. Even though I eat a fruit salad and chicken salad (with lots of raw veggies) and green curry chicken at nightI suffer no pain. I've even stopped the 40 minutes of slow walking mandated by the Doc after each meal. I *do* take soda water with every meal (for what it's worth. I'll stop someday and find out), and chew my food down to microscopic bits (sometimes spitting out things I can't reduce to this level). I take biologically active yogurt every other day (but I was doing this before when I was in pain).

Perhaps the biggest difference is that now I'm taking a very energetic hour walk every other day, despite the heat. I feel power, health and relaxation after I'm done. I suspect the relaxation is the important thing, since I suspect much of my gastroparesis is due to worry and overthinking caused by my long time curse, OCD.

A treatment that mitigates my obsessive worrying is NAC (otc at many vitamin shops in the US) and I started taking that again, even though it's a bit rough on the stomach going down. It works very well to shut down my brain and the churning tightness I feel in my stomach (and body in general)

An herbalist friend here told me that ginger is good for gastroparesis. According to her it helps open and close the valves in the digestive track, including the one from the stomach to the duodenum. Have yet to try this advice, but will. I've also used an anti-anxiety drug (Lorazepam) if I find I can't control anxiety in any other way. (Writing this, I realize I sound like a wreck. I'm for all appearances a witty and friendly fellow and a popular member of my hotel, dare I say so myself....but I have an 'darker inner world' as I'm telling you...).

Anyway, thanks for all the help and comments, especially to Sheryl for her dedication to all our collective miseries, and especially for her research on treatment in the US, which I may eventually need.

Just wondered. I'd rather not carry my passport around everywhere. Easy to loose. On the otherhand, I don't want to get hauled off to jail. I'd also get a copy of my current visa. PS I'm a US citizen.

It may be irrelevant by now, but I said I'd post Dr. Rungsun's gastroparesis report when I dug it out of my camera, so I will. It's not the clearest report or the best picture I took of it, but it makes its point.

I'd been experiencing upper abdominal pain and vomiting after meals for the past 4 years. Sushi, fresh vegetables, yogurt, and cottage cheese were they only foods that never made me sick. Two months ago, I was throwing up blood after drinking some grapefruit juice and took an ambulance to Bangkok Hospital. The next day they gave me a total gastrectomy. Now my stomach problems are over. I can't say enough about the wonderful care I received from my 12 day stay in this hospital.

Jesus H. Christ! And I thought *I* had problems. Well, maybe it'll come to that for me too. Thanks for sharing. Glad your misery has ended.

The test you had at Bumrungrad was a barium swallow, not the same thing.

But as long as other possible causes (gallbladder disease, pancreas) have been eliminated and you are feeling better may not be so important. Should you get worse and need to consider gastric stimulation or pyloroplasty, anyplace doing this would first do the test I mentioned.

Ok, thanks for setting me straight on that.

I'll keep working on this puzzle and hopefully figure it out on my own. It's all new and the feedback on actions that you take is sometimes not obvious to read. So it's trial and error, many errors.

Anyway, glad you're with us!

>The gold standard diagnostic test for gastroparesis is something called gastric emptying scintigraphy. It involves eating a meal that includes a small amount of radioactive isotope which can be traced by an external camera. They then measure gastric emptying hourly for 4 hours. If at 4 hours more than 10% is still in the stomach, the gastroparesis diagnosis is confirmed.

good that you are going to the hospital. As a temporary measure they may need to put in a feeding tube.

Minor feedback.

Bumrungrad Gastro dept gave me every test under the sun for a total of $900. My general internist there (who I was seeing for other reasons) couldn't believe the over testing of the gastro dept.

Doctor summary: I process a barium meal in the alotted time so I have no gastroparesis, despite Dr Rungsun showing me pictures of food in my stomach after 7 hours and inflammation of the stomach lining. Apparently my takeaway is supposed to be "find a good barium restaurant" but my real takeaway is don't go to Bumrungrad for Gastro. It's absolutely the most incompetent hospital dept. I've seen anywhere in Thailand. Both times the doctor was over an hour late.

I've been dragged in several times to see the wrong doctor by the nurses too. "You don't seem to be Mr Chuppawat", the doctor says, and the nurse just giggles and sends me back to my seat (and you've already been waiting an hour and a half because the doctor I'm supposed to see didn't show). Behind reception is Sanuk time (Thai Happy Hour), laughing, joking and generally ignoring the patients. I felt like leaving a stink bomb after my last visit, but what they really need are smelling salts and a good beating!

Ok Sheryl. Thanks again for the work. Glad you're on my team. The newness of this has thrown me for a loop. I'm not even sure I believe the diagnosis yet, or at least its permanent nature. I suppose I'm in "the denial stage". So be it. Right now I'm having enough problems just getting adequate nutrition. My eyes have starting seeing spots and going out of focus and I'm weak as a kitten. I nearly got run over yesterday by a taxi cab. I go into Bumrungrad tomorrow and hopefully they'll have some idea what's going on. I certainly don't. Anyway, I expect I'll muddle through.

Again, thanks for all the time you've taken. If I can't figure things out here, I've got some options when I hit the States.

cheers,

Doug

Do you have Medicare or other health coverage in the US? If so I'll see what I can find out re treatment there.

Yes, I *do* have Medicare (parts A and B, though no "supplemental").

I realized I was underestimating my physical vitality in my writeup yesterday. Before the stomach problems arrived, I made it a point to take a vigorous walk for an hour over the Rama 9 bridge, around the park and few times and back. In a trip to Ko Chang Noi of a month ago I spent hours a day going up and back the trails (you can get away with it there: lots of shade and a breeze), and felt pretty good. I'm tall and lean and was always in reasonable shape, even taking to walking the hotel stairs when the outside became too oppressive. This was all before setbacks with broken bones which slowed me down, and seeming allergies to Thai food which put me on my back for days at a time.

Somehow I'm going to get an hour of *serious* walking in here, despite the heat (the doc told me my 40 minute post postprandial walks are *not* to produce any exercise, just for giggling my food southward). I think somehow I do better if my body's tuned up a bit.

Another thing you may be interested in: there's a guy on Reddit.com/gastroparesis who says he manages food by drinking a few bottles of soda water with every meal, though it has to be one of the more powerful versions (Chang's is much more gassy than Singh for instance). It all sounds like nuts, I know, but I've downed a few meals yesterday which would have normally done me in, with no ill effects using Chang Soda Water. Time will tell. (I looked and there's no research support for carbonated water).

PS: Thanks for your help with the States. It would be good to have "a point of entry" into that medical labyrinth.

Just an addendum. I knocked off the Tramadol for a month to see if it would improve things but it didn't. I exercised more and that seemed to help, at little bit anyway. Unfortunately (and the heat doesn't help) I lead a pretty bed/hammock ridden life in Thailand and I'm sure that doesn't help. I've been leading this semi-sedentary life for at least 5 years here. The only thing that gets my posterior moving is walking or hiking. If I lived in a temperate climate with half dozen hiking trails out the back (say rural New Hampshire in the US), I'd be hiking half the time and perhaps a lot better off.

There are, but not in Thailand as these are very new therapies. The first digestive pacemaker surgery in Asia was done only 2 years ago, in Hong Kong. If you want to pursue options in Asia, the Chinese University of Hong Kong is where to go and if you google it + gastroparesis you'll find the doctors names.

Depending on where you are from, returning to your home country might also be an option.

Aside from seeking treatment outside Thailand, the other thing you could try is acupuncture which apparently helps some people. But it needs to be done by someone familiar with the disorder or at least understanding that the vagal nerve is involved and able to target it. Could try the Chinese Medicine clinic at St Louis hospital.

I assume you are not taking any opiods or othet drugs that might be causing thid?

I can travel, so suggestions out of SEA are welcome. I live in BKK but thought of returning to the US to explore solutions not available here. I wouldn't know where to start as far as doctors who are knowledgeable and experienced with new treatments.

In answer to your question, I was taking a tramadol, 50mg/day for a long time due to the pain of sleeping on a string of shoulder fractures due to my osteopororsis. I talked to Dr Rungsun about this and he said it was permissible to take Tramadol (cycling with Paracetamol and other OTC pain killers) to mitigate gastorparesis pain (the bellyache and nausea), and that he said Tramadol slowed mainly the lower abdomenon (the intestines), not the stomach so much.

I realize it's not a great idea but it's the only drug I have that brings me some relief so I can at least think to work on the problem

I've been diagnosed by Dr. Rungsun Rerknimitr that I have Gastroparesis (the diagnosis was simple: didn't eat for 7 hours, then a tube into the stomach revealed lots of undigested food and an irritated stomach lining). His treatment prescription, made through a drug post op haze (which I went back to clarify) seems to be to simply "eat smaller meals" and walk 40 minutes after each meal, which I've been doing religiously (despite the heat) for 2 months and am still in pain and nausea most of the time. I've also tried meds like Domperidone and Erthythromycin with no help.

And I've also gotten sicker and sicker and sicker, thanks to the prohibitions against fruit and vegetables (my bellweather mouth infections have started again (no fresh fruit)) and in general I feel like regurgitated pad thai. I am not a happy camper, and am considering such experimental therapies as a digestive pacemaker and duodenum surgery. Not nice to get old (I'm 69).

Are there any experts in this field I might consult as to effective treatment?

thanks in advance.

I have been using Linux for some 10 years now, occasionally had Clam AV installed but not currently. Noted that Comodo has a free Linux AV and tried d/l but it just does not d/l for Mint 64-bit.

AVG also works on Linux

I tried an upgrade from 17.2 to 17.3 (about 2 months ago) and Cinnamon crashed every few hours. I submitted bugs on two sites with traces but not a single reply Perhaps if I'd done a fresh 17.3 install? Anyway, I went back to 17.2 and have decided to wait till LM 18 in May or June.

I'd like to get a mostly alcohol liquid (in contrast to 40% vodka) to make herbal extracts. Does anyone know of a Bangkok source?

Thanks in advance

Actually for my son, who needs Photoshop CS6, which only runs on Yosemite, not El Capitan, so need a good service center to backup the current OS (El Capitan) completely to external disk, and then install Yosemite. The Mac is a only about 2 months old, a "Retina".

PS: I don't think his machine was upgraded from Yosemite, so I doubt that he'd have the simple option to "rollback" a version of Yosemite which was already installed on his system (ie I think the first OS X installed on this machine was El Capitan)

They guys are great. Back up their sales also. Highly recommended:

http://www.invadeit.co.th/

Another recommended it also. New to me but I'm glad to hear about it. I've been looking for an online IT place that isn't Lazada prices.

Buy it anywhere that has a good price for the item you want. As mentioned in the first reply, Western Digital will handle the warranty directly.

Their service center is at Pantip. I took a faulty WD Passport there a few months ago. They scanned the barcode on the product to check that it was still covered, and gave me a brand new one right there on the spot with no questions asked or hassle at all.

Of course, lost data is not covered- only the hardware.

I was well pleased with this outcome, and Western Digital is now my brand of choice.

Good info. Thanks!

I bought one in Zeer Rangsit and I have had no need for a warranty it has been perfect same for a 1TB Hard drive I bought for my desktop. I have never had a problem with a WD drive although I am sure there are some people who have

My 1TB WD passport crapped out after about 3 years. It's done some travelling, though I've never dropped it or bashed it around and it always goes on "carry on" on airplanes. 3 years isn't bad, and of course everything is backed up, but it's time for another. Cheers!

Have in the MBK at the 4'th floor shop of Power Buy or the second chaine store,

they give original warranty.

Thanks much!

I do all my IT stuff buying at Fortune Mall now. Never had a problem there. Another alternative is Invadeit.th.co.

Seems like fairly reasonable prices too. Maybe I'll do my online purchases there. Thanks

I'm buying a 2TB WD Passport drive and want a warranty (one that is honored if need be). And recommendations for reliable shops there?

thanks in advance

Thanks all. I'll give the METV approach a try, and fall back on a Laos visa if that fails.

My son is here on a 6 month multiple re-entry visa (the new type as of November or so). I've heard that with proper timing, it can be extended to 9 months as described below. I wondered if this is just "theoretical" speculation or does it actually work this way. Since this visa type is less than 6 months old, there aren't any field reports yet whether it works this way **in practice**. -- thanks in advance.

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This actually means up to 9 months if you time it right. Get the new visa 2 weeks before you leave for Thailand, then come and go as you please making sure you fly back into Thailand a day or two before your 6 months run out. That way, you get a full 60 days from that day, plus the option to extend it for another 30 days without leaving the country, giving you up to 9 Months in Total!

Example: If your 6 month visa is valid from January 1st to June 1st you can come and go as much as you like during that time for up to 60-90 days at a time, then just make sure you re-enter Thailand before May 31st, and you'll get 60 days from that day + an option to extend it for another 30 days, giving you close to 9 months in total.

http://www.johnnyfd.com/2015/10/thailands-6-month-multiple-entry.html

Ok, thanks guys. That's what I thought.

I posed this question as myself to simplify things. It's actually in aid of my son, who just moved here a few days ago and is doing design work ( photoshop) for large projects for his old NYC company where 350mb files are put into the pipe every day. We've been having problems with data corruption on large files going to Dropbox, and debugging that is using a lot of the 12GB so that reserve is dropping fast. I wanted to preserve that data limit for as long as possible by selecting low band width for the small stuff. But no problem. It'll work out. The hotel we stay at is very reasonable but the wifi is dreadful. I'll find a "cheaper" way to debug the Dropbox corruption problem.

Again, thanks