FBN

Today I visited San Pa Tong market for some shopping.

I often wonder if people select their avitar to refect their personality?

Yes, I'm sure; but I always get served politely

A google search for 'Hypoglycemia pre-diabetic' brings up a few results.

Are they wrong?

Not sure which articles you are referring to but hypo (low)glycemia results when there is a high circulating Insulin level in the blood stream but no glucose to act upon (the role of insulin is to transfer the glucose molecule across the cell membrane in all the body's systems to enable the cells to "burn" the glucose for energy.) Resulting in "hunger".. This can result in coma and death if prolonged. This is the risk of the "Type 1" diabetics who are dependent on an injection of insulin. These people does not produce insulin or a chemically abnormal insulin that has no effect, inject insulin but then has to be sure to take in enough carbohydrates to last them as long as the injected insulin lasts.

"Pre-diabetic" states are sometimes diagnosed when someone has a glucose "intolerance"; A test that used to be done was the "glucose tolerance test" where the patient is fasting and then given a glucose loading (about 50g, if memory serves) by mouth. Serial blood glucose tests are the done. Fasting, 30 min, 60 min etc and the glucose levels plotted on a graph.

Some people have a limited "supply" of insulin and run out of insulin before such a high dose of glucose are "used up". Or they have a congenitally abnormal insulin that is only partially effective in transferring the glucose into cells. Resulting in persistent high glucose blood levels ie "Type 2" diabetics. These people may be able to control their blood glucose by limiting sugar intake.

This thread may all be about "glucose intolerance" rather than pre-diabetic states but may be an early warning sign that the pancreas is a bit tired and not managing the secretion of insulin as well as it should. There is a negative feedback system in the brain that controls the whole lot and that may also be not as efficient as it should; but that's another story!!

This is a bit simplistic but, for fear of boring the pants off other forum dwellers; it is about it.

Ishe does have one child so has had sex before in her previous marriage and claims there were no problems though it is not easy for her to talk about her former husband for reasons I do not want to talk about here. It does not involve problems relating to their sex life.

Without looking at the psychological factors that may or may not be involved, the best is to determine if there had been any physical trauma with the first delivery. Was it a normal vaginal delivery or caesarian? Did she have a tear or episiotomy (cut during the delivery?) that was repaired afterwards?

Any trauma could have left scar tissue behind that would cause narrowing and pain as well as bleeding.

It is imperative that she be examined by a trusted O&G physician. The bleeding (unless it was close to her period) is very suspicious of previous trauma.

Don't worry, you're absolutely normal.

In pretty much every culture, a sweet is served after the main course.

Except in ancient Roman times where something sweet was served BEFORE a feast. The sugar (glucose) stimulated an overproduction of Insulin which would in turn stimulate hunger, allowing the guests to eat more.

In Indian culture it is sometimes done too..

I refuse to eat soup to this day; I still enjoy solid food. I know, one day, I'll be sitting there, drooling on my chest and being spoonfed soup till the end of days. Don't want to go there now..

I always pray: Please, may I lose my mind before I lose my teeth...

Time to stop treating side effects of antibiotics with more antibiotics.

Had you read the thread, perhaps you wouldn't have made such a presumption.

Not being cynical, condescending or facetious; I am aware of the Mobi saga right from the Pseudomemranous colitis thread before and it reads like a comedy of errors.. My sympathy is fully with the poor OP!!

We have the TV experts on the one side, taking stabs at, and being confident about a "definite" diagnosis; prescribing treatment and hoping for a moment of glory when the poor OP, yet being subjected to another course of medication, will come back to the forum with a confirmation of a miracle cure. Then the Thai docs on the other, trying to figure out what the underlying condition is in what has become a very complex problem. Most of them, as is clear in the thread, has taken the "easy way out"; prescribing antibiotics and/or a handful of drugs in a "hope for the best and get the farang out of here" approach.

In principle, treating side effects of medication with other medication is not appropriate at best and ill advised and dangerous at worst. For the doctors involved, dealing with a complicated case such as this has become, is also a nightmare.

The bottom line, usually, is get back to the basics.

Everybody on this thread wishes the OP only the best, I am not an exception..

I can just imagine the visa runs

Maybe the word "run" would be not really the right one....

Visa crawls ??

Visa "Shuffle" maybe..

Visa "Roll" for those who use other means..

Visa "Two-step" for the lads with the walking aids...

Thailand immigration's worst nightmare!

Imagine "forgotten" renewal dates; lost passports, broken hearing aids, misplaced false teeth... All happening in the visa office!!

FBN,

He has history of MAC. I have been unable to get definitive info as to whether this could cause a positive QFG. Do you know?

Dear Sheryl,

The QFG test is specific for the M. tuberculosum complex but not other mycobacteria..

I can just imagine the visa runs

Maybe the word "run" would be not really the right one....

Time to stop treating side effects of antibiotics with more antibiotics. Time to stop treatment and allow your poor battered gut to try and revive and heal itself. Take some probiotics, even some charcoal to adsorb any possible toxins and go on a light but varied diet to help it out. Give it some time and don't inflict further insult to injury..

http://www.cdc.gov/TB/pubs/tbfactsheets/LTBIandActiveTB.pdf

Useful article and reference for my post #23 above.

Weird and wonderful advice...

Just get a fasting/random blood suger done before indulging any of these fantasies, will you?

Anyone wondered why or where the noise comes from when you "crack" a joint?

It is a simple phenomenon of a vacuum created within the joint and the snap is caused by airflow not the bone itself; it has never been proved to cause arthritis to my knowledge..

Maybe you should refer to yourself as the "Kellogs Kid" !!

Earlier studies using skin testing with sensitins from atypical mycobacteria, such as M. avium or M. scrophulaceum, indicated that about half of the positive TST reactions in military personnel following return from missions were false positive (3). New diagnostics like QuantiFERON-TB Gold in-tube (QFT-GIT) have been developed using the TB-specific antigens ESAT-6, CFP-10, and TB7.7 (1, 7, 15). The advantages of these new assays over the TST are the higher specificities (excluding false-positive results due to BCG or environmental mycobacteria), logistic simplicity, and need of only one patient visit (9, 14, 15, 17). In this study, we used QFT-GIT for screening military personnel.

Every thing I have read indicates the QFG is not the gold standard of TB testing, due to the higher specificity. I do feel a lot better, since using Zyrtec. My apetite has come back in full bloom! So yes, I have TB, but I do not think it is active. I plan on getting another x-ray in 12 weeks.

If I take INH and then get exposed to TB 2-3 months post torture of the meds, I will be just as likely to aquire the bacteria all over again. Unfortunatley this is the one of the many "gifts" Thailand has to bestow on it's people.

Positive skin test followed by positive Quantiferon with negative chest X-ray usually indicates latent TB. The regular, accepted management for this is INH for 6-9 mths. According to some papers, given the above test scenario (latent TB) you have about 10 - 15 % chance of developing active TB. This can be avoided by taking INH.

The choice is up to you (given the potential side effects of INH) but it is strongly recommended that you protect yourself. At this stage, it can still be considered preventative rather than curative treatment. There are a few excellent posts from OPs that have gone, and are still going through the ordeal of resistant TB treatment; this is all valuable knowledge, read some of those.

Best of Luck!

1) tested montoux 2 days (estimated) post exposure (negative)

2) tested tine test 3-4 weeks post exposure (negative)

3) tested montoux 8 weeks post exposure (positive >15mm)

Please get a Quantiferon test done before assuming active TB.

Current sore throat is very unlikely to be related to previous TB exposure.

Be sure to have throat swabs done for culture and treat specifically.

The Qataris are still driving around happily in their Landcruisers for about 3.5 THB per liter...

My colon cancer has advanced to stage 4 since surgery 18 months ago. I did not have chemo at that time. Cancer has now spread thoughout the abdomen and into the liver.

One oncologist told me I might live a year with no treatment or two years with six months of intense chemo treatments. This was at the large Bangkok hospital the Thais call Chula.

Anyone had chemotherapy at a any of the Bangkok hospitals? I already know it costs about 150,000 Baht every two weeks for up to six months. I think my tri-care insurance will pay 80%.

Comments please.

Mike

Mike,

Tricare has selected providers for different services in Thailand. The appointments and advice is managed by a medical assistance company in Bangkok. For commercial reasons and forum rules I can't mention the name here but can give you the address and contact details if needed. They may be able to assist with scheduling appointments, payments etc.

Good Luck!!

Interesting question. Could it have anything to do with enzymes?

From the FDA Health Advisory:

"In order to minimize risks of myopathy and rhabdomyolysis (the most severe form of statin muscle injury), the revised label now explicitly states that the 5 mg dose is available as a start dose for those individuals who do not require aggressive cholesterol reductions or who have predisposing factors for myopathy. This includes patients taking cyclosporine, Asian patients, and patients with severe renal insufficiency."

Does not seem to have anything to do with enzymes, just a higher risk of myopathy...

News to me...

How about: How has Thailand and being here made you a better person; changed/improved/enriched your life, taught you things, made you appreciate life and living?

Three women: one engaged, one married, and one a mistress, are chatting

about their relationships and decide to amaze their men....that night all

three will wear a leather bodice S&M style, stilettos and mask over their

eyes .

After a few days they meet again.....

The engaged girlfriend said: 'The other night, when my boyfriend came back

home, he found me in the leather bodice, 4' stilettos and mask. He said, 'You are

the woman of my life, I love you...then we made love all night long.'

The mistress stated: 'Oh Yes! The other night we met in the office. I was wearing

the leather bodice, mega stilettos, mask over my eyes and a raincoat. When I opened

the raincoat, he didn' say a word. We just had wild sex all night.'

The married one then said: 'The other night I sent the kids to stay at my

mothers for the night, I got myself ready, leather bodice, super stilettos

and mask over my eyes. My husband came in from work, grabbed the TV controller

and a beer, and said, 'Hey Batman, what's for dinner?'

You will not get a 6 month's supply at one go anywhere. These are all scheduled drugs and subject to particular restrictions. It would be essential that you have a letter from your GP to present to customs when you have a substantial amount of these drugs on you. In this region, you risk serious consequences.

It must be me then; I did that questionnaire in the Health Forum and it tells me I am at least 126...

DORMITORY:

When you rearrange the letters:

DIRTY ROOM

PRESBYTERIAN:

When you rearrange the letters:

BEST IN PRAYER

ASTRONOMER:

When you rearrange the letters:

MOON STARER

DESPERATION:

When you rearrange the letters:

A ROPE ENDS IT

THE EYES:

When you rearrange the letters:

THEY SEE

GEORGE BUSH:

When you rearrange the letters:

HE BUGS GORE

GAUTENG:

When you rearrange the letters:

GET A GUN

THE MORSE CODE:

When you rearrange the letters:

HERE COME DOTS

SLOT MACHINES:

When you rearrange the letters:

CASH LOST IN ME

ANIMOSITY:

When you rearrange the letters:

IS NO AMITY

ELECTION RESULTS:

When you rearrange the letters:

LIES - LET'S RECOUNT

SNOOZE ALARMS:

When you rearrange the letters:

ALAS! NO MORE Z 'S

A DECIMAL POINT:

When you rearrange the letters:

IM A DOT IN PLACE

THE EARTHQUAKES:

When you rearrange the letters:

THAT QUEER SHAKE

ELEVEN PLUS TWO:

When you rearrange the letters:

TWELVE PLUS ONE

AND FOR THE GRAND FINALE:

MOTHER-IN-LAW:

When you rearrange the letters:

WOMAN HITLER

Any more good ones?

The OP did not state age of the patient or level of the blood lipids and/or any other health info such as BP and any other underlying diseases such as diabetes etc.

Statins, as any other drug, has its place but may also have unwanted side effects. Do not start this medication with out a proper assessment. There are specific indications for it; stick to those.

Diet will not reduce or change the blood lipid profile significantly over such a short period. (2 months); stick with a proper diet, excercise etc and re-test in 6 months or so.

Just about the only condition affecting that joint (and the middle finger next to it) is osteoarthrosis. An X-ray should show typical signs.

This is age related and genetic and may appear from about 45y upwards. Tends to pain on and off but the usual anti-inflammatories help most times. It is chronic but usually not a debilitating problem.

Some people experience an increase in discomfort with acidic foods and drink. (Tomatoes, orange juice etc but not to be confused with gout.)