MeaMaximaCulpa

FWIW I still use a TM-30 from 2017 at Jomtien Immigration, and it is always accepted without comment. I live at the same address and I am on a retirement extension. I have been abroad many times over the years, and also travelled locally and stayed in several hotels here. Never a problem. But as always, YMMW...

From what I can understand, it is more the individual doctor and less the hospital you should look for. That being said, it is probably a higher density of excellent doctors at Bumrungrad than at some of the cheaper hospitals. But since a knee replacement is of critical importance, go for the best you can afford. Imagine the potential pain and misery for years to come if you compromise to save some money.

Never?

Nobody on here can diagnose your memory issues, but I believe as a general rule, a low carb/keto diet will be helpful for brain health and memory/dementia issues. Many now call Alzheimer's for diabetes type 3, claiming it is (among other possible causes) a metabolic disease. Insulin resistance in the brain causes poor uptake of glucose to fuel the brain, but on a keto diet ketones are produced from fat to take over glucose's role in the body and brain (well ±30% of the brain must have glucose, but the rest thrives on ketones). Ketones do not require insulin, so one can bypass the insulin resistance. You can also bypass insulin if you do some intense workouts, look it up (non-insulin dependent uptake of glucose). As for diet specifics others have given you some (mostly) good ideas already. But general rule is Fat 75%, protein 20% and carbs 5%. Then you can adjust to taste. Just be aware that there is a phenomenon called "physiological insulin resistance" or glucose sparing state, as opposed to pathological insulin resistance. The former is not dangerous, but it usually happens on a very low carb diet, where you rely on the liver to make the small amount of glucose the body never can do without (parts of the brain, optic nerve, red blood cells plus some more areas). So the cells are made temporarily insulin resistant to give the vital parts the glucose they need. Eating some carbs for a day or two will quickly turn off this mechanism, so it may be a good idea to cycle in some carbs now and then. How will you know you have succeeded? Two ways: 1) Get a ketone meter, similar to a glucose meter. This may be difficult to buy in Thailand, also via the internet (e.g. Amazon will not ship it here), so you will have to have a friend ship it to you or trans-ship it via a third party (FDA approval rules I believe). I have one (Keto-Mojo) and it works very well. Together with a glucose meter (I use Accdu-Chek Guide, very good) one can track accurately the progression to keto nirvana, also nice to have if you do some prolonged fasts (3-4 days) every now and then. 2) You will just know! After a "fat-adaptation phase" of 2-4 weeks you will not be hungry much, cravings go away, energy returns, brain fog lifts and mood is much better than on a carb heavy diet. Weight loss should also be quite easy. The adaptation phase may be hard, and there you will need some self control. Many give up just before they arrive in fat-burning mode, so stick with it!

Perhaps talk with your dentist if ceramic inlays may be a better option for big fillings?

I had my amalgam fillings removed around 30 years ago, and replaced with polymer fillings and in some cases ceramic inlays (for bigger areas on the chewing surfaces). My dentist back then in South Africa (RIP (the country, not the dentist)) did a very good job of preparation for safe removal both for him and me. In addition to things already mentioned in this thread, to avoid any drilling residue entering the throat and swallowed he put a rubber "coffer dam" tightly around the tooth and covering everything else. I didn't have any specific symptoms of mercury poisoning, but did this as a precautionary measure, since it is usually old, partly broken or eroded fillings that can eventually leach out mercury. I also didn't have any adverse effects of the removal, nor did I feel any better for that matter. My blood mercury is stable and low now and back then. Some will say "let sleeping dogs lie", since the risk of extraction vs the benefits may be hard to calculate. The mercury in amalgam is usually very tightly bonded, and unlikely to cause any harm (except to the dentist who used to work in this environment all day, every day). I can see that side of things, same as with a root canal treatment. I would prefer extraction and implant before a root canal, but if you already have a root canal that has been done by a good dentist and is not causing problems, it may be better to let it stay. But there is a risk that anaerobic bacteria can build up, and eventually leach out and get into your bloodstream. And these bacteria can be very dangerous to the heart especially. But again, the very process of drilling into this "can of worms" may help to spread the bacteria. Like a biopsy for cancer detection. Very useful, but may in some cases help to spread the cancer. So doomed if you do, doomed if you don't...

I usually don't comment in this section, but I enjoy the entertainment value. The above post was way to big to bother commenting on, but one sentence stood out to me: "... the days of imperialism are long since dead". Are they? Really? You (and I) might wish that to be true, but last time I checked, many of the left/liberals/... keep saying that they KNOW what Putin wants. And that is to re-create the Soviet Union and invade Europe (exactly HOW they know this is a bit unclear to me, and likewise how Putin would go about doing this isn't obvious with his limited resources and economy). And China, well we can observe that they are on all continents, busy investing/buying up ports, land and building big things with thick strings attached. But they also flex some military muscles, so far mainly in the South China Sea, but also elsewhere. Feel free to disagree, I don't really care. I just had to point it out, that's all.

2nd hand black Lotus Turbo Esprit, bought at Hendon Way Motors in London way back. I don't have a pic handy, but the one below looks the same. 2.2 liter turbo, double overhead cams, double Delorto carburetors, it felt like sitting in a go-cart with poor to no visibility other that straight ahead. <deleted>ty build quality, but fun to drive and it turned some heads. It had KUW 777 in the reg. number and was registered first time 25 December. The dealer said it was a prince from Kuwait that bought it as a Christmas pressie to his g/f or wife. I dunno if that is true or not, but it is a good story nevertheless. James Bond used a white version in a 007 movie in the Italian alps, and had a trendy ski-rack fitted. So James and I are buddies 🙂.

OK, I am not answering your direct question, but you can get blood tests done also at clinics. I use N-Health in Pattaya, they have decent prices and there is no charge for seeing a doctor. So if you know how to interpret the results, it is a good deal.

I agree that Greek yogurt is the best, since it is usually full of good fats as well. Beware low fat yogurt, since they will replace the fat with sugar to keep the taste and mouth-feel. For plenty of good protein eat organic/free-range eggs, fatty fish and grassfed beef.

I will attempt to answer your first question. Water is water no matter what form it has, so yes fruit (or e.g. coffee or beer) will add to your water intake. Now the downside is that fruits are very sweet, and each gram of sugar will require around four grams of water to "process" in your body. This water is not part of your hydration as such, as it gets stored. This is also true for beer which contains a lot of sugar (carbs). Coffee and beer also have the effect of being diuretics, so therefore drinking coffee and beer will dehydrate you, requiring you to drink even more water. Finally hydration has to do with salt as well ("water follows salt"), so if you drink too much pure water without enough salt (and electrolytes), the body cannot hold on to the water. But that doesn't mean it's a good idea to drink seawater, because that is another can of worms altogether!

OK, I have to bite one final time: Many lived much longer, but sure, falls, wild animals and infections culled quite a few. So way too simplistic for my liking. No thanks, more of the same (bad studies) doesn't make bad science good. And you keep talking about processed meats, which I agree are not good for you. My point was red, unprocessed meat (perhaps I was not clear enough earlier). Please let's leave it at that, I respect your right to have whatever opinion you like.

My last word on this here, since the OP didn't ask for this discussion, and we're highjacking his thread. The study you quote is as I guessed an observational study, based on questionnaires. This type of study is very unreliable and can at best indicate correlation and not causation. For that you need a randomized double blind placebo controlled study. A correlation can be used to form a hypothesis and can indicate where to do further study, but not to draw causative conclusions. If you seriously want to learn about this more in depth, you must put aside your preconceived opinions and look much deeper, otherwise you just will suffer from confirmation bias. Look for Peter Attia, Chris Kresser, Mark Hyman, Mark Sisson and many others to learn more. Eat what you like, full on vegan for all I care, but be aware that humans have eaten red meat (but not processed meat) for hundreds of thousands of years and thrived on that. Why should it suddenly be dangerous? Answer that question and you will get closer to a real answer. Good luck!

I know this issue is controversial, but I think if you do some research with an open mind you will find that the studies that point to red meat as colorectal cancer risk are mostly observational. And often not well enough corrected for confounding variables. It tends to be the sum total of what red meat eaters eat, drink, smoke and do w.r.t. lifestyle that can increase the cancer risk, not the red meat itself.

I would be careful with multivitamin/mineral tablets, since several of the ingredients may be harmful if you get too much, unless you specifically are deficient. Examples from the list you provided are: A, E, B6, calcium, potentially also selenium. Edit: I would also mention iron, don't take unless deficient. Better to eat some red meat 🙂.

Hello @backstreet I have experienced similar issues so I know how hard it can be, and what I find is that some simple meditation helps. Also a gratefulness routine is good, every day think about what you can be grateful for that day, instead of focussing on the problems you see (real or imagined). Proper breathing is very important, and learn how to use diaphragmatic breathing or breathing with your stomach. Look this up. The 5 minute video below with Andrew Huberman explains how to do something called the double sigh, a very useful technique to use when you need to slow down your heart rate to go to sleep. Or to reduce stress during the day as well. It really works, and quite quickly! As for medication: I would stay far away unless deep clinical issues, and focus on better eating (low carb/high fat) and whatever exercise you can manage to do within the limits of your foot injury and age. As for supplements, magnesium has been mentioned, I would add one which is GABA, a calming neurotransmitter I think it is classified as. I take it before bed (2*500 mg), and it can seem to give me better sleep (difficult to know for sure what causes what). You can buy it from iHerb.com, they ship to Thailand and is the number one website for supplements, with very good product range and an excellent customer service. Meditation and gratefulness are both good, and some personal therapy with a good psychologist might also help. But you have to find a person you "click" with, otherwise it will not work very well. I wish you good luck with finding some calm and peace, we older gents should live a quiet life, and not worry too much! 😀

Thanks a lot Sheryl, I will check this out. I am actually seeing a doctor at Rutnin at the moment, but not the one you mention. But since I will not be in Bangkok regularly after new year, I hoped to move to a local hospital. I have a thinning of the optical nerve sheet as seen on OCT scans, but with normal eye pressure, and no real, clinical symptoms of glaucoma. So my doctor asked a colleague as well, and they both could not explain fully. So I need to monitor, but for now no treatment. I will talk to my doc about getting a 2nd opinion from your recommended doc (hope no loss of face...). And to go once or twice a year there is OK, but they still insist on wearing a mask, they even tape it on your face... As for my question number two, my wife is Thai but quite westernized, and can check out the resources you highlighted. She will also be Pattaya based after new year, but once she finds a therapist she is comfortable with, they can do video meetings. So again, thanks and good to have you back, you're a great help to the community! MMC

Welcome back @Sheryl, I hope you had a nice break and are not too busy helping your big flock to answer my question! Today no "conspiracy theories", only recommendations for "real" doctors 🙂. Btw, this is not only for Sheryl, please let me know good and not so good experiences from everyone who can contribute. 1) Glaucoma specialist at Bangkok Hospital Pattaya to investigate, monitor and treat possible early glaucoma. Another hospital in "the 'hood" can also be considered if warranted. 2) A good "behavioral psychologist" at Bumrungrad Hospital, but also at Bangkok Hospital Pattaya. Individual (non-hospital) practitioners can be considered if warranted. I am not looking for a psychiatrist with a big bag of SSRIs to "treat" mental illness, but someone who can help my wife deal with and process both old emotions (mainly family related) and current (to do with complex and traumatic work dynamics). Thanks for all help! MMC

Recently at Jomtien they wanted TM30 (from 2017 accepted), TM47 and PP copies.

OK, my bad

I tend to go mid week, arriving a bit after 09:00 (I hit my bank 08:30 same day for the bank letter/800K which is always accepted). By then most of the eager beavers are through the system. I have in all my time at Jomtien Immigration (at least since they moved from town) NEVER got my passport back the same day for retirement extension, regardless of time of day. As in NOT EVER. Last year it took two days even. So I am surprised to see this issue even being discussed. I guess it is the same as I have NEVER, for anything I need to do at the Land Transport Department in Pattaya been able to use my yellow book/pink card as proof of address, but have to get a certificate of residency at Immigration (who in turn uses my yellow book. Oh, the sweet, circular irony of it all). But still there are people saying they can use their yellow book, and I must be unpresentable or badly dressed or drunk who doesn't. Go figure...

@Sheryl you are of course correct in the fact that we have no studies on humans with anti-parasitic drugs. However there are some very encouraging anecdotal cases worth checking out, more with Fenbendazole than with Ivermectin. And knowing that big, randomised, double blind, placebo controlled trials are very expensive and will never be funded by big pharma, when there is no potential to recover the investment. The drugs in question are out-of-patent, cheap and generic drugs, and safe for humans. Would I try these drugs if I had cancer? You bet I would, why not? Would I turn down traditional treatment? That would depend on the specific case, type of cancer, progression, probability of cure, etc. There is also now renewed interest in Otto Warburg's close to 100 year old theory of cancer as mainly a metabolic disease, where most cancers prefer sugar as fuel (apparently pancreatic cancer cells can also thrive on ketones). The damaged DNA theory has not yielded much in terms of inroads into beating cancer, and the drugs in this class are extremely expensive and not that effective. There is now some who thinks that the DNA damage is not the direct cause of cancer, but rather a result of damaged mitochondria. More research is obviously needed here, but it can seem promising. So there is more to this complex problem than we might think, and if we do not try simple, safe and cheap alternatives we will have to wait a very long time for big pharma and the established medical science to help us. And we better be rich!

I have also heard about this. Another anti-parasitic drug called Fenbendazole is also reported to have anti-cancer effects. Very interesting, since mainstream medicine seems to have been stuck on another track for quite a while.

There are some that would claim that a healthy diet is high fat, but not omega 6 seed oils. Animal fats are the real deal, and restrict the carbs instead, especially grains and processed sugars. Protein depending on requirements.

Hi guys, A brief update to those who helped with specific information I can use. The immediate "crisis" is over, and my old pool shop is back on track with regular cleaning. But for the intermediate and longer term I still need more help, since the problem is potentially much bigger than cleaning and say change a filter or pump. But just so you know I do appreciate the help you've given me so far: @MrJ I did stop by JN pool shop on Sukhumvit with my wife the other week, and we got a very good impression, especially with the lady we chatted to. The shop itself looked well stocked, clean and tidy, to me a good sign. Jack was not there, but I will call him later and see if he wants to come by to have a look and a more in-depth discussion on things he can help with. @Bagwain Sorry I still haven't gotten back to you, but I will when I get some more time to spare (late this year or early next year is my guess). As I mention about Jack above, if you like you too can come round for a coffee and a talk. I need to look at several options, and we also need people to help with all other house maintenance tasks into the new year and going forward. Brgds MMC