richardjm65

Just to round this out, yesterday I was able to find boxes of 30 X 3.95gm (1500mg) water dissolvable glucosmine sulfate sachets distributed by Bangkok Drug Co., Ltd., manufactured by Bangkok Lab & Cosmetic Co., Ltd., at 420baht/box. Worth a try.

Thanks again Sheryl, jtmedic and p_brownstone. I did consult 2 orthopedic doctors at the military hospital in Korat. The first waggled my knee about, did not bother with x-rays and prescribed Glucosamine which, as I said, seemed ineffectual in the dosage prescribed over the time frame of a couple of months. The second doctor (who was recommended heartily by the staff) did order x-rays, told me the erosion of cartilage was too great for Glucosmine to affect, pointed out what he called 'spurs', and suggested that knee joint replacement would be the answer.

I had greater confidence in the second doctor. I have not consulted yet on the hip, as it occurs to me that possibly limping to favour the dodgy knee might well throw strain on the hip on the other side, thus causing pain. I think I'd be inclined to try the glucosamine (without the chond), at elevated dosages for three months, coupled with the home treatment and exercise suggested by Sheryl. I'm a little overweight (72kg) and inactivity to rest the joints seems to have reduced muscle mass whilst growing a bit of a pot.

I'm on 5mg/day of Warfarin for the DVT and was concerned that exercise might result in a pulmonary embolism, but if you feel that moderate exercise (stationery bike, walking and so on) would be safe and beneficial, I'll get started. I use Difelene gel to rub into the knee and when in pain, use an elasticated knee support. I also take Difelene tablets (1 x 50mg) twice a day. If I do not take these, there's a definite increase in pain levels in both the hip and knee. For the DVT I also use a foot to thigh support stocking - it's on the leg without the knee problem.

Thanks again for you interest and helpful posts.

Thanks, Sheryl and jtmedic. In another post, Sheryl mentioned the brand name 'Kirkland' and though this was for another product, I think this was the brand name recommended by a friend, who is convinced of the efficacy of Glucosamine/Chondroitin in his own case.

The link for Glucosamine was interesting and I noted the caution directed to those who use blood thinners, (which I do), for DVT. So, I'll consult with my DVT doc before trying them. I also noted that if positive results from its use are not noticed within three months, then perhaps they should be discontinued. I did try Glucosamine/ Chondroitin for a limited period, in small doses, as recommended by my joint and bone doc, with no discernible result. Another doc has suggested tripling the dosage.

I guess it's worth trying for a three month period at elevated dosages, if the blood thinner issue can be resolved. If it fails, then I'll have to resort to something else - perhaps hip and knee replacement - which would be expensive. Any other suggestions would be gratefully received.

I'm up country and cannot find Glucosamine 1500mg with Chondroitin 1200mg. Anyone know where I can order this from for delivery by mail? I want to try this in elevated dosage to try and avoid the necessity for hip and knee replacement.

You might want to look around for the PML brand Fish Oil 30/20 1000mg ( EPA 300mg, DHA 200mg). They're manufactured in NZ and re-packaged by The British Dispensary (L.P.) Co Ltd. here in Thailand. They're marketed and sold by PML Pharmaceuticals Co Ltd, Tel: 02-330-8550. They're a bit pricey at (I think) 420Baht for 60 capsules but the recommended dosage is 1 capsule/day. They might be a bit cheaper in Bangkok. Probably available at most good pharmacies.

I forgot to thank you for the link which I'll study, and I'll post again if I have further queries.

^^ Could be thread in itself your suggestion/question above.

Actually I remember you relaying your story in another posting some time ago, but at the time maybe I was distracted by more interesting things.

My DVT ended in one of the clots breaking away and lodging in my lungs = 10 days in hospital.

I remember the INR reporting well to my local GP (doctor). Also the initial of Heparin into my tight 6-pack ... nebulous stomach fat reserves ... maybe 10 days to 2 weeks?

After about 12 months on the Warfin, we had a discussion with the GP and decided that the 100mg of Asprin should be the go for the foreseeable future ... that was 4 years ago.

Here is the one of the Australian Governments brochures about the use of Warfin ...

Be better soon ...

EDIT ... forgot the link ... http://www.health.wa..._warfarin_B.pdf

Yes, if the clot, or part thereof, breaks loose, it rushes through the circulatory system, makes for the lungs, causes a pulmonary embolism, (which is what you must have had), and which can be fatal. You were fortunate, David. Although this is slightly off topic, (sorry, OP), it still bears discussion. As I now understand it, the Heparin and the subsequent Warfarin thin the blood sufficiently to prevent further clots. The clots which you already have must be dealt with by one's own defence and dis-armament system, which is often imperfect.

And yes, I did address this subject some time ago, but with little response. Clearly DVT is not a condition to be taken lightly, which is why I still seek enlightenment as to what, exactly, the blood tests mean. My uneducated guess is that they refer to a range of blood viscosity. Right now, I have no pain, swelling or internal heat. A year down the line, am I cured? I just don't know.

As an aside, the hospital wanted to keep me in for the daily Heparin jabs, which I could not abide the thought of. We persuaded them to give us a few days worth of pre-loaded syringes which, having been instructed how to administer, my wife was able to do quite painlessly, I should add.

Since you're posting 4 years down the line David, I'm assuming you're now all well?

I had a DVT once and was prescribed Warfin.

After a time on that drug, the doctor recommended the standard 100mg Aspirin tablet as a routine blood thinner ... taken once a day. The standard size of 'headache' style Aspirin is 300mg.

What dosage do you take?

Do you fancy a red wine at night ... also said to thin the blood.

I'm no doctor ... just my experiences.

.

I was diagnosed with DVT a year ago and was hospitalised, on a drip, plus additional potassium. Doppler U/S scan confirmed the presence of clots and I was initially treated with injections of Heparin (which I understand takes immediate effect), followed by Warfarin, which I'm still on, with blood checks every 2 months. The checks, I presume, are to monitor blood viscosity but due to language difficulties, the doctor is unable to make me understand exactly what is being measured and compared with what during these checks. Typically the readings would be:

Result Flag Ref.

PT 16.1 8.9 - 14.3

INR 1.19 0.64 - 1.17

For about a year my Warfarin dosage has remained the same at 1 x 5mg tablet once a day at bedtime. Can anyone enlighten me on the blood test parameters and the difference between using Warfarin as opposed to Junior Aspirin?

I do believe the red wine is a good idea too.

As mrtoad has pointed out, it's a difficult situation when you understand that you're the person in the frame for a situation, (not of your own making), and which you are not qualified to either deal with effectively or financially. I well know, from personal experience, that the public hospitals offer quite efficient diagnostics and treatment. I am not in a position to haul him off to a hospital and cop the bill - I wish that I were.

I've advised his partner that re-hospitalisation is, essentially, what is required and that it is necessary for her to raise cash by whatever means necessary, so she must sell whatsoever can be sold, and then negotiate with the bank over the sale of the house or re-scheduling of the mortgage. She cannot rely on the financial goodwill of family or friends to support him at home when it is obvious that he needs proper care in hospital. I cannot afford further financial support, but am now trying to contact his other friends to see if they're willing to help. I don't even live in the same town, so that's not so easy.

I originally heard, via the grapevine, that he was sick and offered what help I could, but it's gone far beyond my resources now. I totally agree with those who have advocated hospitalisation. I'm just not sure how to achieve that.

I believe this. I am persuaded. Where do I sign? D'you need my PIN number? Praise be!

Thanks Frits (#74), Hedgehog (#75) and Briggsy (#78) for your helpful comments. Much appreciated. I'm amazed and humbled by the kindness and compassion offered.

I still fail to see why everyone thinks he would be better off in the UK

I agree. But it does depend on his medical condition. If he requires long-term nursing, and has no assets, the UK probably would be the best place for him. Those, however, who do have assets above £16k (or have they increased that figure?) would be required to pay for nursing, and if I was in such need I would spend those assets in Thailand where the money would go further.

On the other hand, if he could receive treatment to enable him to have some sort of life he should at least get a proper diagnosis before he decides what to do. I must say I don't think much of his partner, to whom he seems to have outlived his usefulness, so she just tries to dump him at the British Embassy. I must be one of many who are helping to support aged and ill family of our loved ones. It's a pity to think that the Thai ethos of "looking after family" doesn't appear in some cases to extend the other way, even to the limited extent of getting some checks done at a local hospital.

This, I think, is not quite fair. Far from trying to dump him at the British Embassy, his partner managed to get enough cash together to take him to the Embassy staff who, it transpired, were unable to offer either help or advice and, indeed, had no wish to even see him. I was contacted as a last ditch resort - something I did not invite, and my assistance, so far, has been limited to financing the fruitless trip to Bangkok, with a result I'd already predicted.

We will try and find a way of getting him hospitalised and, hopefully, properly diagnosed and appropriately treated. I do assure you that the partner is doing whatever she can, but with little to work with, she's now reliant on goodwill and the charity of those who know them. To put it as succinctly as possible, she finds herself in a situation where she simply does not know which way to turn.

There have been some interesting responses. I should make clear that I might well agree with some of the more 'robust' posts but the reason for my first post was to seek opinions on what might be possible to improve a bad situation, rather than make judgement on past actions and events. Putting a problem like this out for discussion helps to clarify thought processes and perhaps focuses attention on the immediate problem, which is that of getting an accurate diagnosis and effective treatment before worrying about the immigration and repatriation problems.

I will suggest to the partner that she really has no option other than to try to raise money by selling the house - this means talking with the mortgage provider (probably the bank). I now agree that rather than try for repatriation he should be placed in a hospital as a matter of priority. One step at a time.

Thanks for the replies so far. To answer a couple of queries, he never served in the military. He is not yet of pensionable age. It's a bit alarming that he would still be fined for a visa overstay, and since he has no money, the alternative would be to stick him in the immigration jail. And there he'd stay.

It looks as if his best option is to lie low until the end. The thought of dumping him at the embassy gates did occur, but I reckon he'd be picked up by the BIB and finish up in the immigration lock-up.

I know this is a long shot, but thought I'd see if you guys know of any organisation who might be able to assist in the repatriation to the UK for a very sick man. The story as I know it:-

1) The guy became sick about 4 - 5 months ago with a problem with his eyes, balance and, I suspect, mental processes. He has no money, and the UK family are unable/unwilling to assist. His visa expired back in June and was not renewed, probably because of a combination of lack of money and his inability to get to an immigration office. I believe he might be excused the overstay if his doctor can produce a letter stating the health situation. He has no medical insurance back-up. I reckon he's lost about a third of his body weight from not eating properly.

2) Though not officially married, he has three children who are not yet in their teens. In better times he took on a nice house and a shophouse, both of which have to be paid for and his partner is way behind with the payments to the bank.

3) She's unable to work as the children need care and he needs 24/7 attention.

4) He was taken to the British Embassy on Monday, his partner hoping for his emergency repatriation. The embassy said they were unable to help and would not even see him.

5) I'm not sure if he'd be allowed to fly, given his condition, and I believe that an escort would be required.

6) Even if that could be achieved, with no support back in the UK the only option that I can see would be to get himself sectioned, as he's long been out of the UK and probably would not be able to get emergency NHS treatment for what is a pre-existing condition. Having not lived in the UK for many years, I don't know the routine for getting sectioned.

It's a difficult situation - we've helped as much as we're able. I've suggested that his partner talks to the bank, offering the possibility of moving out of the house to the shophouse to reduce overheads and selling the house.

Any useful suggestions would be welcome. Other thoughts that occurred might be trying to interest one of the Brit newspapers or maybe the Salvation Army. Any ideas?

Looks more like a human finger.

Chef's special!

Jails what fixes drug addicts.

Tough love. Not a shoulder to cry on.

If even half the tales I hear of life behind bars in Thailand are true, jail would seem to be the one place where a regular supply of the drug of choice is available - much of it coming by courtesy of the guards. Some years ago I talked with a prison warder from the UK and the question of drugs came up. His response was quite a surprise - he said that the prison authorities tended to turn a blind eye to the in-house drug deals, the reason being, apparently, that it kept the prison population quiet and controllable by the prison staff which, too often, was badly under-manned.

I would not expect that attitude to be greatly different in Thailand, but I guess it would depend on how well you're fixed for cash. I reckon I'd agree with Jim when he says that many of the inmates become regular repeat offenders. Do the jails actually try to deal with the addiction? Is it really possible to give specific treatment to individuals? I rather doubt it.

All that can be said is that once the addicts are inside, they're not on the outside causing trouble in their quests for money to feed their habits.

Yep! ate Fido in the Philippines. I thought it was sort of sweet and a bit gristly and bony. On the beach I lived on, there were no barking dogs. If they barked or snarled, the locals would first break their backs with a lump of wood, then kill and butcher and usually barbecue them. I was not much impressed by that. Neither did I like the method employed to kill pigs. A good pig would scream for up to 15 minutes after having its throat cut. Shaving the animal prior to butchering would not require that it was entirely dead. Generally, given the Filipino appetite for the ears and <deleted> of most animals, not much was left for the scavenging dogs.

I've never craved dog as part of my regular diet. How many Filipino restaurants are there in your home town?

From the research I've done on yaa baa, ( for a friend whose wife is into it), the psychological effects are quite horrible, with mental changes that may or may not be reversible, depending on the specific drug used and the period of usage. The use of yaa baa in our small town has skyrocketed in the 15 years I've been up country, resulting in a significant rise in petty crime, home burglaries and muggings. Home security becomes a matter of priority and it's not entirely safe to be on the streets late at night.

I don't know of any re-hab programmes locally. The solution offered by the police is prosecution and jail. (How useful is that?). They seem to manage to thin out their numbers that way, or by picking up the bodies after lunatic 'bike accidents. I guess you have to wonder why this might be. Given the poor educational standards, the loss of family land to deal with debt problems and the unavailability of worth-while employment, it might be a result of desperation. Mostly, our locals cluck-cluck about it, but tearfully defend the reputation of their sons when they get nabbed or killed in accidents or local violence.

Until the social problems of rural Thailand are addressed, things will only get worse. But there's the rub - who wants educated farmers?

Saw da vid. Man, back in dem days, dose black boys wus really short. You dig?

I've had three more good reads since Don Winslow's 'Savages', which have been Tony Hillerman's 'The Dark Wind', Michael Connelly's 'A Darkness More Than Night', and best of all, James Lee Burke's 'In The Moon of Red Ponies', which is another in his Billy Bob Holland series.

Now I'm waiting for something new to read, and whilst waiting will take another shot at 'Another Roadside Attraction', by Tom Robbins. Found this at the bottom of my old dive bag and noted that it's probably been there, gathering funk, since 1975!

Yes, Bookman, you're correct, I mis-spelled his name. Sorry.

Have recently finished the three books shown under.Each one a ripping good yarn in the Wilbur Smith style.

Have just started reading this one.

I too have read a fair number of Wilbur Smith's books and enjoyed them. I did wonder if he might be getting a bit formulaic with his later stuff - but perhaps it's just me getting used to his style.

If you like books about Africa, there's one writer I read in the 1960's who I thought was very good, although I can't remember seeing any of his books on shelves in LOS. His name was Robert Rourk and I guess he probably wrote about a dozen books. I remember 'Uhuru', 'The Honey Badger', 'Something of Value' and 'Use Enough Gun'.

He died quite young, probably as a result of a profligate lifestyle. I seem to recall he was compared by some to Ernest Hemingway.

Well he is going to have a long stop at my house, some kids have put out 4 tall bottles of beer on ice for him !

Are you anywhere near Lahansai? If so, advise soonest - I might just beat him to those four bottles!

I can only agree with the cautions suggested so far. It's not your game. The aggrieved will, at some time, find his own way of dealing with it. Could be a year or two down the line, but the grudge will not be forgotton. There's a hierarchy in each village and the police and residents in those villages understand that. There's nothing to be gained by you, (a foreigner), trying to enforce what you perceive as justice by calling in a higher authority - it just won't work.

Far better to avoid setting yourself up as an easy target, no matter how angry you may be and however much you may disapprove of the injustice. Keep out of it. Thai village customs and law work their own way, in their own time. There will likely come a time of reckoning.

Stay cool.