lsemprini

By the way, a little off-topic but sharing with this group of migraineurs. I recently received some advice on meds to use for migraines from a Harvard Medical emergency doctor friend of mine. These are the treatments he used for his patients and also his migraneur wife. I ran these by another friend who is a neurologist and she says this is sound advice (with the only caveat being that some migraineurs are not so much struggling with how to abort their current headache, which the advice below focuses on, but rather have the problem of headaches coming back in subsequent days in a cycle, which the meds below do not address but also do not make any worse). I have not tried any of these (other than sumatriptan) and don't know which are available in Thailand, but thought the advice might be useful to this group. Be sure to do your research before trying any. ----------------------------------- BEGINNING OF QUOTE: On the migraines, yep, avoid caffeine, except that it can be an effective abortifacient. Here are the tools you should have in your medicine cabinet. All can be taken simultaneously with no safety risk. You should use injectable or nasal sumatriptan at the earliest sign of a migraine. Injectable sumatriptan is far more effective than the oral form. The nasal form is not as effective as the injectable form, but is much more effective than the oral form. So efficacy is injectable > nasal >>> oral. (Those are “greater than” signs.) Prochlorperazine (Compazine) is a fabulous migraine abortifacient. It can cause some people to feel jittery or have a weird cramp in some part of their body...this is NOT dangerous but can be frightening...this side effect is easily treated with diphenhydramine (Benadryl) [though it is NOT an allergy], so, often, we just go ahead and presumptively give a Benadryl tablet or ½ a tablet when we administer prochlorperazine. Take prochlorperazine 10 mg (perhaps with a half or whole tablet of Benadryl) at the earliest sign of a migraine. [Those of larger physical size e.g. 100kg] may need to take 20 mg of the prochlorperazine, and that’s fine, so don’t hesitate to repeat the 10 mg dose after 20-30 minutes if no effect. Metoclopramide (Reglan) is another fabulous abortifacient. The aforementioned side effects can occur as with prochlorperazine, though somewhat less commonly. Dosing is the same, and this medicine is so safe that it doesn’t even matter if you take both together. For clarity, it’s okay to take sumatriptan + prochlorperazine 20 mg + metoclopramide 20 mg + Benadryl, all at the same time. Of course you should figure out the lowest possible number of medications and the lowest possible doses, because we always want to avoid these chemicals, but I just want to be clear that I’d rather you take the above than have to go to the hospital and face that horror show. Caffeine and NSAIDs are very effective abortifacients, but you face the risk of rebound. For some people who get migraines infrequently, some caffeine and a couple Aleve tablets does the trick. When my wife feels a migraine coming on, I give her 10 mg of metoclopramide and 1-2 Aleve tablets, together with a diet coke if it’s not bedtime, and this is almost always curative...almost instantaneously...usually after 10-20 minutes. It is okay to take caffeine and NSAIDs together with all the other medicines (sumatriptan, prochlorperazine, metoclopramide, and diphenhydramine). It’s a rare migraine that doesn’t get crushed by this combination, though usually just one or two of these meds is needed.

Interesting...to be clear though, does your other half also feel that original sumatriptan (Imigran/Imitrex) does not work? In other words, is the objection against sumatriptan in general or the generics Sumigran/Siagran specifically?

Interesting points, but even for motorbikes, surely there are things a technically knowledgeable person could check for that could benefit a non-technical client? For example, when purchasing a used motorbike it seems the biggest ticket item would be when the engine needs to be rebuilt with new seals (often costing 5000-10000B, which might be near the purchase price of the motorbike)...surely there must be some tests a mechanic could run that can predict how close this event is more precisely than just smelling for smoke when you turn the motorbike on? I've seen several bikes that had no visible/smellable smoke on purchase but that required engine rebuilds within 6 months of purchase....avoiding that would be a valuable service potentially worth thousands of baht.

That's the problem---for someone who is not familiar with the technical details of auto maintenance, they have no idea what that list would contain, and they have no way to tell which mechanics have experience with their vehicle type. This is exactly the dilemma for non-technical people who want to evaluate a potential purchase. If they already knew those things, they wouldn't need to hire a third party inspector (at most they'd need to visit a shop and order up specific tests they already know about). And yes as gamb00ler said, it's not only about being ripped off, but also a question of finding a mechanic with vaguely the same standard of what is acceptable wear and tear vs. what is a red flag that should dissuade one from purchasing. If some entrepreneur takes up this role and establishes themselves with positive reviews from non-technical used vehicle owners who are happy with their purchase even in the long-term, then that entrepreneur would make a lot of money. Especially if they can offer the service in English and meet the needs of farang vehicle owners.

For people who are thinking of buying a used motorbike/car but who are not auto mechanics experts, is there some kind of trustable service in Chiang Mai that will give an unbiased (meaning not in cahoots with the seller) evaluation of a car/motorbike for a fixed fee? Something similar to the AAA vehicle inspection service in the US. Ideally the service provider would have access to equipment needed to make a good inspection that goes beyond superficial things like looking for smoke coming out the exhaust pipe. Where to find such a service and how much? One good location would be near the large secondhand vehicle markets in Chiang Mai. My friend is looking now and I've seen people ask about this multiple times before...clearly there is a market for something like this. But so hard to know who is competent and actually unbiased...

I found Sumigran at a chain called Fascino in Chiang Mai; looks like they have 3 Fascino in Pattaya too.

No need to import; Lorry was just being helpful by seeing if sumatriptan is available from reputable producers in other countries at that price. Sounds like 15B is actually the market price, not the 150B we've all been paying GlaxoSmithKline even 13 years after their patent expired.

Mostly safety concerns (contaminated meds for example) since I don't know the producer and want to hear from others before swallowing their product. Apparently different types of med have very differing difficulty to produce and different ease of accidentally introducing contaminants or producing the wrong molecule, so even if a producer "gets it right" for some meds, it doesn't necessarily translate to their ability to produce sumatriptan. I have no idea where sumatriptan falls in that spectrum. Second concern would be fake pills that don't have any active ingredient. The price made me suspect that, but sounds like 15B/50mg might be the actual market price (finally seen, 13 years after patent expires).

Thanks! My doc is in the US, so I'm on my own for evaluating Rx Chumchon. So far I've just learned it's a Thai pharma factory put together by a bunch of independent Thai pharmacies. One Thai pharmacist who used to work for Pfizer says he's not surprised about the price difference given Big Pharma gouging, but then again he sold Sumigran.

What went wrong?

Has anyone ACTUALLY tried the new Thai Sumigran sumatriptan migrane abortive for a reasonable period of time and what can you report? Does it work? Does anyone know anything about the Thai maker, Rx Chumchon aka "Community Pharmacy Public Company Limited" ? I have been purchasing GlaxoSmithKline's pricey Imigran/Imitrex sumatriptan migraine abortive for decades and very interested to see there is now a Thai version. The price is insanely lower, 10x. One headache (50mg pill) of Imigran/Imitrex is approximately 150B whereas 1 headache (50mg film-coated tablet) of Sumigran is approximately 15B. Both are supposed to be 50mg sumatriptan succinate with no other ingredients. The price difference could be due to the insane markups of Big Pharma, or it could be due to corner-cutting and fakery. Glaxo's patent on sumatriptan expired way back in 2009, so either industry collusion kept the price high until now, or there's something dodgy about the local brand.

For future reference, out of the ~20 shops I called/visited, the only one that even has Waves in their fleet is the very nice people at Yayee rental on soi 88 https://maps.app.goo.gl/h8W8F4KkyRy89nCw5 but their bike was out when I was looking (and one of the owners was using the other one!). Seems like a business opportunity for rental places.

I have ridden a Dream in Thailand for the last 20 years and simply prefer the clutchless gear bikes for several reasons (but Dream is effectively discontinued, so Wave is the only model I have a chance to find). One is just that I'm used to them and so easier and safer right out of the shop. Another is more control of engine braking going down hills, though that matters more up in the mountains where I live (there are quite a few places where I live where one simply cannot go with an auto bike, because you will certainly slip out on dirt roads downhill; the Waves/Dreams also have significantly larger wheels and more clearance). Another is that the design of the Wave/Dream allows me to easily carry my big bag because the space between the front edge of the seat and the handlebars/fairing is much larger on those bikes compared with the autos, and I DO plan to carry my big bag some in Hua Hin. Another is it's just a bit annoying how much extra noise one is forced to make with the auto bikes at slower speeds, because the bike chooses the gearing, not the driver. None of those are critical but I'd still prefer the bike type that I am familiar with. The autos let us be lazy and have more storage space, which is nice, but not worth it for me.

Looking to rent a Dream/Wave/Shogun/... type non-automatic clutchless motorbike for a week or two. Seems nearly impossible to find, but maybe someone still has them. I just called every rental place listed on Google for Soi 88 and Soi 94, no dice. Thanks

All good questions. I believe my server and client are both OK because as I mentioned in the OP, I never had problems when connecting to the same server from the same client (same laptop computer, software, setup) over a CAT connection. Only when switching to a TOT connection do I get the endless drops. My old house used to have 2 fiber connections so I was able to switch back and forth instantaneously and the pattern was clear. And now in my new house where I have only a TOT connection, I am seeing the same drops that I saw with TOT in the old house.

It would appear that I am not behind a CGNAT because my fiber ONU's external IP is the same as my whatismyip.com ip Just curious, what weirdness does CGNAT cause that regular on-premisis NAT doesn't also cause? On a related topic, my external TOT IP address changes, but only about once per week (I have been tracking it). So that is DEFINITELY not the source of the hundreds of ssh drops per day that I often see.

Yup thanks, ozimoron suggested that above and I tried both the ssh-level and TCP-level options to disable timeout, but sadly that didn't fix it. In my case, the connection drop happens regardless of whether the connection is idle or actively sending data back and forth.

Yes it was not a company VPN, but rather a VPN server running on a relative's external router at a home address in the US. Normally when I am using that VPN server, I don't experience any new drops of long-running TCP connections (in other words, that VPN doesn't add any new drops that wouldn't also be there without the VPN). But when I used that VPN recently, I was still seeing ssh drop just as often as explained in the OP. So either the drops are from something as yet unidentified on my PC or in my TOT router, or the drops are from something in TOT's network that targets traffic based on packet size/timing (since the VPN traffic no longer looks like ssh traffic, but still has the same general pattern of packets over time). Another thing I noticed recently was that the drops happen a heck of a lot more during the daytime and especially early evening, which tends to point more to TOT's network since that is the busy time, and not so much late at night. But will collect more data there. Apropos tgw's earlier theory, I suppose it is possible that TOT's network redirects all my HTTPS requests to some edge caching server which has good and proper connectivity with the rest of the internet, whereas TOT's network directs other traffic (like ssh) to some faulty network that drops TCP connections left and right. I could try to set up some random server on the internet at a random TCP port to see if TOT drops those connections too.

Another datapoint: I tried turning off my Avast antivirus (because I noticed the horrible thing was intercepting all https traffic via a hack driver and substituting its own certificate so it could spy on my traffic, so who knows what else it was doing to other outgoing TCP connections). Initially that seemed to make a difference, but psyche! the drops were soon back. So no go there either.

Another datapoint: I had a wired TP-Link Archer AC1200 router between my computer and the ISP's ZTE F612 modem/ONU (but everything gigabit ethernet, no WiFi). I temporarily eliminated the AC1200 and connected direct to the ZTE, same problem.

Well I can do that, but as I mentioned, all other network access continues smoothly (even long HTTP downloads continue) while the ssh is killed left and right, often many times per second. So it seems unlikely to be at layer 1 since it uniquely affects the ssh traffic.

Also random datapoint is that the server is running ssh on port 2233 instead of 22 (not within my control).

I did try screen for some operations, but it doesn't work for all the things I need to do (keep a long rsync from my house computer for off-site backups running, for example). And of course screen messes up anything that uses fancy terminal/curses stuff. I don't think it's a server issue, because I never had the problem from my old CAT connection, and the admins of my shared hosting server did look at logs at one point and simply saw the sshd disconnect without any particular error (i.e. it looked like a normal client disconnect to the server). They verified that there is no process killing going on on the server side (which they would only do for out-of-memory, but not even that is happening).

Interesting idea, but in the case of a flaky router we would expect to see all TCP connections affected the same, right? I am able to keep big HTTP downloads (even those running in a command-line wget process with a single HTTPS connection, as opposed to a browser that might have a pool of open TCP connections to a given server) flowing with no problem even when ssh shells are killed left and right during the same download.

I already established that using the CAT ISP does not show this problem. I suspect it would be the same with my AIS 4G connection via hotspot, but sadly I can't use that all the time due to limited speed and data cap. I could test temporarily but not sure if that adds much new data. I already normally connect my computer to the TOT router using gigabit ethernet (I get full 600Mbps up/down to Thai speedtest server), so WiFi is not the source of the problem (no WiFi in use anywhere). Any other ideas?