PMNL

May the gentleman rest in peace. My deepest sympathy to his family and love ones.

Just a warning in general to non well informed customers/ patients. Before you take any action MEDICALLY recommended by the podologist. Please check it out with your trusted health care professional. Many unlicensed treatments were done unethically, Fact.

Mod; Feel free to delete this post if I break any rules.

1, "sugar diabetes"

2, No idea maybe constant get worse after time, often fall when standing up or moving, light headed, can just be sitting in a chair and vision gets blurred.

3, Thai Enaril.20MG......... ?? Now doing a search on Google shows this is for High Blood Pressure ?? maybe years ago Pharmacy gave me wrong ? always take the old bottle and get new one the same....... Never thought of looking before at the pills

+++ take PRENOLOL 100MG table at day ???????? No idea what is for

+++ take GLYCON/CLAZIDE 60MG a day ??? No idea what is for

+++ take Bestatin 20MG day ??? No idea what is for

+++ take NEOFORMIN 500MG 2 x 2 a day [Diabetic pills]

+++ take Miracid 20MG a day [acid stomach]

To my opinion, Could it be that you had heigh blood pressure several years ago and were prescribed Enarapril and Atenolol? And now your blood pressure is lower (might be weight loss, exercise, diet control or something) but you still be on the same pill which off course lower your blood pressure even more. You definitely need your meds to be adjusted. There is normally a reason that doctor prescribed you the meds ie Enarapril for Diabetes with Proteinuria, Atenolol for DM with angina, so you should go back to talk to the one prescribed them for you or one who can talk and advise you properly. I do believe they will cut down the two meds or leave a half dose of Enarapril depends on your curent blood pressure.

For the neoformin; metformin is blood sugar lowering agent, bestatin is cholesterol lowering pill, glycazide is another blood sugar lowering meds. Miracidvis for gastritis/GERDSo you must have been diagnosed with

1 Diabetes

2 Hypertension with hypotension ( side effect from high blood pressure pill)

3 Dyslipodemia

4 some type of gastritis ( I guess they as well prescribed you with aspirin?)

Your problem seems to be lack of communication and information regarding your condition and meds informations, hope you get it sorted out soon.

Another good option for Songkran is at Ob Khan Gorge. Very popular too, but a bit more local and very scenic. I was there recently and they were setting up some bamboo stalls to sell stuff for the festival.

BTW I was out yesterday and didn't notice anything unusually wrong with the moat water, nor has there been any advisory. Remember local kids are swimming in it.

Isn't it obvious just at a glance the water is not clean. The local kids swim in any water and who garantee those little naughty don't pee and poop in the suppose to be Songkran water; just a thought. The Huay is popular place for local so it might be crowded by the way.

what's special? you can get priority services anywhere paying money!

I think the UK Border Agency is now run buy the same twot in charge of Ryan Air, charge for everything!

Or Air(bloody)asia?

Bloody useless and financial motivated as usual for UK embassy. Say if someone is in need to travel urgently for the funeral for instance.

3000 THB addition and waiting 3 days, the deceased would turn into ashes by the time the visa granted! if they can make it happen in one day with that money then worth a bribe!

I dont know whether thing has changed but even US embassy is very picky with grating their visa, they return the fee and do not rob you blind like UK does.

Perhaps Allergies normally can not be cured but control.

Yes ,I have. I have no desire to be a "BLUDGER' on the Thai Govt..and their medical or health care system. Do you have ANY understanding of the term "BLUDGER. You like being a BLUDGER?. Because ,you obviously are one, a BLUDGER that is .I am more than happy to pay my way. I really resent your tone of voice.In fact ,I am quite disgusted by your accusation that I have learnt nothing.Yes .I am an old age pensioner ,but I am more than happy to pay for my medical expenses, given that they are ,relatively so small. Compared to our home countries. If you are not a pensioner.Sorry, but something tells me you are not a very nice person. Am I right?

Entirely up to you 'afarang', whether you choose to use what's open to you, or not. I object to you calling me a 'BLUDGER' as I am certainly no user. I, in all my years here, have never asked, or been given charity. The insistence of my obtaining my 'gold card' (free treatment) came from hospital staff where I live. I'm as much part of the community as they are, and I most definitely contribute more to the Thai economy than they do as individuals. Hence why they considered it appropriate to be as one with them. It isn't a question of whether I can pay or not. It's was a gesture offered to me by them. What do I do ? Say 'no' and offend them, or accept their invitation ?

Sorry, but something tells me you are not a very nice person. Am I right?

That "something" ain't your brain. Have you tried the other end ? Because that's where you're talking from.

I would not call you a BULDGER or think that you are a BLUDGER, but you have no conscience at all. Those gold card or 30 baht program is allocated to the poor thai and those immigrants who in needs. You are a foreigner in a foreign country, off course you contribute to the community as you have to spend your money on buying your food, paying you own bills but you do not pay tax! I doubt it very much if any local govt would offer any farang a gold card, even with thai they have to register themself to a selected hospital, and yes of course you can accept the invitation, if that is, but think with a so-called brain of your and Pay your own medical expenses and stop abusing the country medical care, and again of course if you can.

I agree that the health test "packages" may be overkill, but certain blood work should be done regularly, even if you don't have symptoms. By the time Bully realized he had prostate cancer, it could have been quite advanced. My father apparently had adult-onset diabetes for years but he didn't seek medical care until he was experiencing neuropathy in his feet. After that, he found he could control his blood sugar levels easily with oral medications. But, the damage had been done by then and eventually he died from a whole host of problems caused by years of out-of-control blood sugar. (I was amazed that he'd never had his blood sugar checked, and he was seeing a doctor regularly for treatment of blood pressure problems! Sometimes the doctors are focused on just one problem and don't consider the patient as a whole) These "package" health tests at the hospitals do a very good job of covering all the standard tests that should be done regularly.

I agree and I don't, you make a powerful case for the patient to make their own checks because the doctor can't always be trusted to do all the right things, at the right time, all of the time - I think one of the major keys is to ensure that you have a good and capable doctor and a second key is perhaps self education that equips the patient to ask the doctor why certain tests haven't been performed and whether they should be.

Well said, It does not matter where you get the test done though, it is important to get your trusted doctor to interprete test results.

Not just glance the report and say normal/abnormal but to tell what is the likely diagnosis/condition when certain test show abnormal figure and what to do/monitor/follow up.

Many time patients were told their tests abnormal but found out later on just a bad stool and urine sample, error report. e

Most important thing is self education so you can ask the right question, request appropiate test if not included in "package'.

A truly positive gentleman, a very nice, kind member of chiangmai expat community and I am sure he will be missed by all , may he rest in peace. My condolence to Ken's family.

Contact any local hospital, you will be able to recieve treatment.

The generic cocktail is very inexpensive, the side effect and failure rate is higher comparing to the original coktail.

Avoid getting meds from private hospital as they are very pricy.

Abandoned MooBaan near hang dong 18°39'10.17"N 98°53'32.99"E

Unsold Houses from the King 2km past abandoned moobaan 18°38'53.72"N 98°52'12.17"E

Am I missing something here?

This is the second time you mentioned house from the King.

Do you mean Ban Ua Atorn?

Lung Function Test : very inexpensive, it should not cost you more than 500 baht, you off course have to pay a doctor fee for result reading.

Go to Sriphat.

combined Hep A and B vaccine is Twinrix cost about 1000-1300 Baht depends where you get, you need three shots at first, a month later and six month after the first one.

Japanese encephalitis is two shot 3 months apart, cost about 600-800B.

Typhoid is a single dose very inexpensive.

If you will be in town expose to many soi dogs then pre exposure rabies shots should be considered.

I am sure that the pharmacy have more business in general.

Many thais and farang just like the easy way of getting drugs without consultation.

It is more convinient but not practically safe, the staff giving advise at pharmacy, mostly are not qualified.

They do not tell you whether you can take the two medicines together or what could be side effect or what should be monitored.

Some of them, I must say, however are very knowlegable, but most of them would just give you anything they know, not the one that you should be taking without contraindication.

Many people do get precribed from doctor then get repeat prescription from pharmacy, in this case, it is safer and problably cheaper.

Did you tip the guy?

Or Metrolex by Siampharmaceutical, the leading pharmaceutical company in Thailand.

Not sure if I get it right, regarding Niaspan, the manufacturer claim that the tablet can increase HDL.

Is it possible that this brand also claim to maintain the level of healthy cholesterol=HDL at its normal level.

I have no sympathy to be honest.

A lot of us know about the book that basically trashes the royal family here. It's not a particularly well written or well researched book.

This guy obviously sees himself as some sort of activist, why else would he be sitting up there in Isaan on using his blog to encourage people to read this trash?

Now he's an activist, he can experience jail time like many other activists around the world.

Pity he didn't take up a worthy cause, isn't it?

Well said. I do believe there are many thais and farangs are misled with all this books regarding HM the King.

Many of them express their mis-informed mind to pubic forum, deserve the punishment.

No direct experience but somebody I know went there and paid a lot(~2500B) for a consultation and treatment.

Also heard that they prescribe some medicine and injection.

Excuse my ignorance but normally podologist can prescribe medication?

Sheryl,

I've had posts and questions about Xatral and now Proscar. You've answered my posts in a professional manner, thank you. Now, my question is, in your opnion, if i go to the doctor and tell him I have an enlarged prostrate and he asks if I have trouble urinating (slow flow, etc), and I say yes, Why would he give me Xatral (for the urination problem) and not Proscar to shrink the prostrate and therefore, take care of the urination problem?

It is impossible for me to say why the doctor did what he did, I have no way of knowing his reasoning nor am I clear on what information he had at his disposal.

It sounds like your prostate condition had been previously diagnosed elsewhere and he was taking your word for it i.e. had not done any diagnostic work up himself, is that right?

Did he at least do a rectal exam? And was he a urologist (specialist)?

As I trust you know the thing of greatest concern with an enlarged prostate is ruling out prostate cancer. I hope that has already been done in your case and that you get regular check ups. If not, would be best to do this rather than trying to self treat.

There is a pinned notice at the top of this forum with some recommendations for excellent, western trained urologists in Bangkok.

Sorry, I should have supplied more information. yes, the doc did do a rectal exam - the urologist at RAM (the guy that should have retired 10 yrs ago). I knew no one could answer my question, I was just venting. Still don't know why he would just prescribe Xatral when he knew I had an enlarged prostrate (have had enlarged prostrate last two years diagnosed from doc in USA). So, I'm thinking, may be best to take Proscar or some generic instead of Xatral to help both my problems - the enlarged prostrate AND the slow/frequent urination situation.

If need be in the future, I will seek out a specialst from Bangkok.

Hi,

I might have missed some information, please correct if I did.

Did you do PSA test recently/ at the consultation?and was it higher than 4 ng/mL?

If not, I think he did the right thing by not giving you Proscar, which will definitely not only reduce the size of prostate but reduce the PSA too.

As urologist have to use PSA to help them making decision whether patients with enlarged prostate should do the biopsy or not to rule out prostate cancer, prescribing Proscar is a bit of substandard treatment then.

While giving away alpha-blocker can reduce your symptom without interfering with PSA, as an important indication to help making a decision in the future, if needed.

As said, If i missed some of your previous information provided, please correct me.

Better stay where you are for the subtype LDL test. Not available as far as I know in Thailand.

More complicated test is sometime just a money making thing, most of health care practitioner still use LDL, HDL, and total chol/HDL to evaluate the treatment and risk od CVD complications.

It sounds pretty much the same as Niaspan.

It should have the similar effect as Niaspan but I do not think noone can tell for sure.

Look up at the price is as expensive as Niaspan so done get what is the point of getting this not well know/trusted brand.

Hi Erik, If she is in Sisaket, you might want to sugest her to go to the ENT guy there called dr. Suthee, He works at Sisaket hospital and has private clinic near by the shopping mall.

I am just wondering could it be lacrimal duct obstruction or allergy which is unlikely as it is normally affect two eyes. Does she have any swelling near by the right eye corner close to the nasal bridge? Any itchiness and dark circle around her eyes? Whether it is allergy or lacrimal duct problem,or vertigo related, I think the ENT should be able to take care of the matter initially.

I appreciate your concern Sheryl, but I was always on beta blockers, on the doctors suggestion. To recap: 50mg Atenolol + 10mg Enalapril, which seems to stabilize my BP at a reasonable 12x/8x. Perhaps you meant calcium channel blockers?

The Atenolol is fine but the Enalapril seems to give me this really annoying, bad, dry cough (listed as one of the common side effects). I was hoping that changing to Losartan would make it disappear but alas, it didn't, so back to the old Atenolol/Enalapril mix for now.

Not sure about Amlodipine, it seems to have some awfully scary side effects. What other options might there be?

I dont know why your blood pressure went up but normally it takes a couple weeks for ACEI dry cough side effect to go away, I have seen this in many cases switched from ACE to ARB.

You may try to take losartan for a longer period of time,1 month for example, and see how is the blood pressure and the dry cough.

Do you split the atenolol as twice a day dose or once a day? In Angina and IHD, most cardologist recommended twice a day dosage.

A low dose of diuretic is not a bad idea to add on to control your BP ( Such as ATENOLOL 50 mg a day Loranta 25 mg a day plus Hydropchlorothiazide 12.5 mg a day)but as Sheryl mention to leave the ACEI ARB isnt a good idea.

Hope you figure out the right regimen for yourself soon.

Good Luck