Good Pulmonologist?

[Batty]

Can anyone reccomend?  Preferably in the North East region but willing to travel to see a good one.  Its nothing serious (I dont think) but something stubborn that I have had a couple of times this year - chest infections that seem to come and go.  I have had 2 x rays in the last 3 weeks and both times the Doc insisted the lungs look clear.  Stress test and blood test all very good.  But I dont know, im coughing all the time and my lungs hurt.  I picked up the latest one after having a cold around a month ago.   This is the third time in 10 months.

 

On top of that I have a throat problem, the back of my throat is red and a little inflamed.  It does not feel like a regular cold/flu type sore throat as it does not hurt to swallow at all, just these low grade stabbing pains all over my throat (like a 2 out of 10 pain wise very low).  That started 1 week ago.  I went to see a local doc who flashed a torch in my mouth for 2 seconds, prescirbed Amoxicylyn and waved me off - in and out in under 1 minute.  After a week on those nothing has cleared so I went to see another Doc yesterday who prescribed Augmentin.  Same deal though - torch in throat, in and out in under a minute, didnt seem to care about the chest infection thing, just shrugged it off.  ANyway, I have had a bunch of dental work done in last 6 weeks, a couple of root canals and a wisdom tooth out, so the throat thing might be linked to that.  A friend of mine mentioned you can often get throat infections after visiting the dentist.  I didnt know that.

 

It might be time to go and see someone at the top of there game - wondering if Sheryll or anyone could suggest a good Doc?

 

While I am at it, would be good to go and get a full screening check up if anyone can suggest the best place to do that.  Im a pretty healthy bloke most of the time but I do get struck down with random illness quite a lot in this last 18 months or so.  Chest infections, tonsylitus, Prostatitis, colds, flu... Never anything serious but way too frequent for a 46 year old bloke, its wierd.  I smoke, but dont drink often, excercise most days and most of the time eat quite healthy.  I had one at Bumrungrad 12 months ago and they said I was in good healthy shape, so I dont understand why I seem to get sick so often.  Might be time for another full screening.  I guess Bumrungrad again?

[Puchaiyank]

You may be suffering from periodic allergic reaction to air pollution...every area of Thailand...and especially the northern provinces have unhealthy air many times during the year...AQI...Air quality index app can help you determine the level of pollution in your area.

 

Your system may react to air pollution by producing mucus which gathers in your sinus cavities and drains down into your lungs as you sleep...causing you to cough when in a reclined sleeping position...over time this can develop into bronchitis and even pneumonia.  Left untreated one may develop asthma...and other related breathing problems.

 

The red throat may also be a symptom of allergic reaction...(I do not drink...but I take a swig of whiskey...sometimes mixed with lime juice and honey for instant relief)...this may burn an irritated throat a little.

 

Try an ENT specialist...go when you have the symptoms...

 

You may get continuous relief by taking small amounts of prescription drugs to maintain healthy breathing...

 

Good luck!

[mike787]

You said NORTH.  However, I recommend Bumrungrad hospital.  Excellent care and doctors are amazing.  PM if you need a specific name.

[SantiSuk]

Where in the North East? My regional capital is Ubon Ratchathani - only one decent pulmonologist there - Dr Suchart (Saturday afternoons at Ubonrak/ daily at Sapphasit Public hospital (don't go there though with its teeming masses if you want to avoid lung infections!) / rather unreliably daily for an hour or so at his private clinic near Sapphasit. PM me for more details if of interest

 

Best general pulmo I came across in Thailand was Dr. Atikun Limsukon. He's at Sripat and Bangkok Hospital in Chiang Mai (or he was 6 years ago). Partly US-trained he is very patient-friendly to deal with - you'll find my 'road trip' report and recommendation of him here (if still available in archives):

http://www.thaivisa.com/forum/topic/511966-chiang-mai-doctors-and-medical-specialists/page-6

 

Bumrungrad Bangkok has the biggest pulmo department in Thailand. I've had variable quality of analysis from their guys - one of the first I consulted 5 years ago was rubbish; kept bullshitting that he knew about my lung condition (bronchiectasis) but everything he said indicated he thought I was talking about bronchitis. They do have a bronchiectasis specialist who knows his stuff, but only there on Thursday morning so that when I was setting myself up for a triple heart bypass four weeks ago at Bumrungrad I engaged a COPD and lung infection specialist named Dr Anon Jatakanon to keep an eye on my lungs throughout my stay. I would recommend him if you need to sort out lung infection symptoms. Yes Bumrungrad is expensive, but not particularly so for initial consultations, imaging and diagnosis (IME generally there). The upside is the the place is unrelentingly professional and clean at all levels and you can get to see a genuine specialist at a few hours notice, having discussed it with a call centre staffed by fluent English speakers. Easy to find specialists with good English who have had at least a couple of years in the US or Europe and all but very junior nursing staff speak OK English too if you need inpatient treatment.

 

As to your symptoms I wouldn't pooh pooh the local docs who gave you amoxycillin and then "Augmentin" (amoxycillin+clavulanic acid). They are fairly standard treatments for unspecified lung infections that are clearly not pneumonia. Trouble is that one week is insufficient for someone who is regularly displaying infections (a very common mistake by non-specialists - insist on 2 weeks of the Augmentin next time. If you are producing sputum (or can huff it up) then get the pulmo to have it tested for specific bug/specific antibi.

 

An X-Ray would reveal signs of cancer, pneumonia and give a strong hint of COPD. It would take a spiral CT scan with contrast for a highly trained pulmo/radiologist to detect bronchiectasis.

 

Give up smoking you idiot [:-)]. Can't understand any doc saying you are in good shape if you smoke (unless very casual). More than 20 pack years of smoking gives you an uncomfortably high risk of developing cancer or COPD and you are unlikely to shake off any lung condition if you insist on smoking. Easy for me to say as one who had added incentive to quit 25 years ago when my then newly-found UK lady friend refused to allow me into her house and bed unless I gave up! I quit straight away. She probably saved my life - I got a treatable/treated MALT lung lymphoma, not lung cancer.

 

Edited July 29, 2019 by SantiSuk

[Sheryl]

1. Go to Khom Kaen University Hospital (Srinagarind), go through the after hours clinic and ask to see on of the acharns from the Div of Pulmonary Medicine such as:

 

Bring your most recent Xray with you and of course details of antibiotics taken.

 

2. You seriously need to stop smoking. While you might not have more than bronchitis now sooner or later you will have worse. Those stabbing pains in the throat are your body telling you to stop.

 

3. I also suggest taking Redoxan/Lascarbine (Vit C plus zinc in effervescent tablets) 1 a day, available at any pharmacy,  helps boost the immune system and decrease frequency and severity of respiratory infections.

 

[Sheryl]

P.S. In addition to pulmonologist , if the throat pain persists you should see see an ENT and insist on an endoscopic examination of your throat. Throat pain in a smoker is not to be taken lightly.

[ThaiPauly]

I quit immediately after my doctor told me she thought I could be developing emphasemia.

 

I had tried to give up more times than I care to mention, but that was the one thing that did it.

 

Two and a half years now, no compulsion to resume my 30 a day habit.

 

Sometimes we need a real shock to make us quit bad habits...consider this yours OP !

[Batty]

On 7/29/2019 at 7:25 PM, Puchaiyank said:

You may be suffering from periodic allergic reaction to air pollution...every area of Thailand...and especially the northern provinces have unhealthy air many times during the year...AQI...Air quality index app can help you determine the level of pollution in your area.

 

Your system may react to air pollution by producing mucus which gathers in your sinus cavities and drains down into your lungs as you sleep...causing you to cough when in a reclined sleeping position...over time this can develop into bronchitis and even pneumonia.  Left untreated one may develop asthma...and other related breathing problems.

 

The red throat may also be a symptom of allergic reaction...(I do not drink...but I take a swig of whiskey...sometimes mixed with lime juice and honey for instant relief)...this may burn an irritated throat a little.

 

Try an ENT specialist...go when you have the symptoms...

 

You may get continuous relief by taking small amounts of prescription drugs to maintain healthy breathing...

 

Good luck!

Thanks buddy.  I have never been a big believer in the air pollution thing because I have lived here a long time and never had it before, just this last year or so.  But you are not the only one who is saying that - most of the times are telling me its probably an allergy.

 

Throat infection (or whatever it is) spread to my ear over last couple days, its totaly blocked and throbbing so went back to ENT who cleared it out and told me to crack on with the pills.  He is still saying its a throat infection thats now spread to my ear, should be fine in a few days he said.  As for the lungs, maybe your right - the antibiotics dont seem to be helping anyway so it could be.

[Batty]

On 7/29/2019 at 7:36 PM, mike787 said:

You said NORTH.  However, I recommend Bumrungrad hospital.  Excellent care and doctors are amazing.  PM if you need a specific name.

Thanks Mike.  Ill see if it gets any worse and if it dosent clear up I will head down there.  Im thinking of doing an anual check upw ith them anyway so could kill two birds with one stone.  Thanks again.

[Batty]

On 7/29/2019 at 11:08 PM, SantiSuk said:

Where in the North East? My regional capital is Ubon Ratchathani - only one decent pulmonologist there - Dr Suchart (Saturday afternoons at Ubonrak/ daily at Sapphasit Public hospital (don't go there though with its teeming masses if you want to avoid lung infections!) / rather unreliably daily for an hour or so at his private clinic near Sapphasit. PM me for more details if of interest

 

Best general pulmo I came across in Thailand was Dr. Atikun Limsukon. He's at Sripat and Bangkok Hospital in Chiang Mai (or he was 6 years ago). Partly US-trained he is very patient-friendly to deal with - you'll find my 'road trip' report and recommendation of him here (if still available in archives):

http://www.thaivisa.com/forum/topic/511966-chiang-mai-doctors-and-medical-specialists/page-6

 

Bumrungrad Bangkok has the biggest pulmo department in Thailand. I've had variable quality of analysis from their guys - one of the first I consulted 5 years ago was rubbish; kept bullshitting that he knew about my lung condition (bronchiectasis) but everything he said indicated he thought I was talking about bronchitis. They do have a bronchiectasis specialist who knows his stuff, but only there on Thursday morning so that when I was setting myself up for a triple heart bypass four weeks ago at Bumrungrad I engaged a COPD and lung infection specialist named Dr Anon Jatakanon to keep an eye on my lungs throughout my stay. I would recommend him if you need to sort out lung infection symptoms. Yes Bumrungrad is expensive, but not particularly so for initial consultations, imaging and diagnosis (IME generally there). The upside is the the place is unrelentingly professional and clean at all levels and you can get to see a genuine specialist at a few hours notice, having discussed it with a call centre staffed by fluent English speakers. Easy to find specialists with good English who have had at least a couple of years in the US or Europe and all but very junior nursing staff speak OK English too if you need inpatient treatment.

 

As to your symptoms I wouldn't pooh pooh the local docs who gave you amoxycillin and then "Augmentin" (amoxycillin+clavulanic acid). They are fairly standard treatments for unspecified lung infections that are clearly not pneumonia. Trouble is that one week is insufficient for someone who is regularly displaying infections (a very common mistake by non-specialists - insist on 2 weeks of the Augmentin next time. If you are producing sputum (or can huff it up) then get the pulmo to have it tested for specific bug/specific antibi.

 

An X-Ray would reveal signs of cancer, pneumonia and give a strong hint of COPD. It would take a spiral CT scan with contrast for a highly trained pulmo/radiologist to detect bronchiectasis.

 

Give up smoking you idiot [:-)]. Can't understand any doc saying you are in good shape if you smoke (unless very casual). More than 20 pack years of smoking gives you an uncomfortably high risk of developing cancer or COPD and you are unlikely to shake off any lung condition if you insist on smoking. Easy for me to say as one who had added incentive to quit 25 years ago when my then newly-found UK lady friend refused to allow me into her house and bed unless I gave up! I quit straight away. She probably saved my life - I got a treatable/treated MALT lung lymphoma, not lung cancer.

 

Thats realy helpful tahnsk for that.  Ill give it another week and if does not improve maybe head down to Bumrungrad.

 

I should quit the smokes, its the most stupid thing ever and realy isnt that addictive compared to most other things, I just dont seem to be able to get my act together and stop!

[Batty]

On 7/29/2019 at 11:36 PM, Sheryl said:

1. Go to Khom Kaen University Hospital (Srinagarind), go through the after hours clinic and ask to see on of the acharns from the Div of Pulmonary Medicine such as:

 

Bring your most recent Xray with you and of course details of antibiotics taken.

 

2. You seriously need to stop smoking. While you might not have more than bronchitis now sooner or later you will have worse. Those stabbing pains in the throat are your body telling you to stop.

 

3. I also suggest taking Redoxan/Lascarbine (Vit C plus zinc in effervescent tablets) 1 a day, available at any pharmacy,  helps boost the immune system and decrease frequency and severity of respiratory infections.

 

Thanks Sheryll.  You are totaly correct about the smoking, I realy need to get a grip with it.

 

Can I just ask, do you know if the after hours clinic applies mid week also?  Like after 6pm or something?  Or is it only weekends the after hours applies?  Actualy I will just call.

 

 

[Batty]

1 hour ago, ThaiPauly said:

I quit immediately after my doctor told me she thought I could be developing emphasemia.

 

I had tried to give up more times than I care to mention, but that was the one thing that did it.

 

Two and a half years now, no compulsion to resume my 30 a day habit.

 

Sometimes we need a real shock to make us quit bad habits...consider this yours OP !

Yes it has been on my mind so much latley.  I have tried a few times over last month or so but can never get past the first morning.  I brought some Welbrturin which apparently are anti depressents but have a side affect that puts you off smoking.  I didnt like the side affects that came with them.  I realy need to just quit - how hard can it be.

 

Congrats for stopping, by the way.

[Batty]

On 7/30/2019 at 12:58 AM, Sheryl said:

P.S. In addition to pulmonologist , if the throat pain persists you should see see an ENT and insist on an endoscopic examination of your throat. Throat pain in a smoker is not to be taken lightly.

Thansk again Sheryll.  The stabbing pain seems to have subsided a little and the inflamation has gone down some, although now its spread to me ear - im sure as the doc says its related to the throat infection but that dosent stop me freaking out a little whenever I google the symptoms, which seem to point towards throat cancer quite a bit!  The ENT said he sees no signs of anything serious like that and told me not to worry, but I guess that kind of thing gets misdiagnosed quite a lot.

 

 

[Sheryl]

The after hours clinic is on weekdays from about 4 - 7 pm (get there early as there will be a queque) and probably also Saturday mornings.

Odds are your throat pain is just an infection (if so it will resolve completely) but the fact that you are getting throat inflammation/infection and chest problems so easily indicates that the protective lining has been damaged by your smoking. Consider it a serioud warning.

Should the throat pain not fully resolve within say another week then endoscopic throat exam is essential. This is more than just shining a light into the back of your throat, it involves spraying a local anesthetic and passing an endoscope way down the throat eo that whole throat and larynx are well visualized. Sometimes sedation is given first.



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[Sheryl]

The after hours clinic is on weekdays from about 4 - 7 pm (get there early as there will be a queque) and probably also Saturday mornings.

Odds are your throat pain is just an infection (if so it will resolve completely) but the fact that you are getting throat inflammation/infection and chest problems so easily indicates that the protective lining has been damaged by your smoking. Consider it a serioud warning.

Should the throat pain not fully resolve within say another week then endoscopic throat exam is essential. This is more than just shining a light into the back of your throat, it involves spraying a local anesthetic and passing an endoscope way down the throat eo that whole throat and larynx are well visualized. Sometimes sedation is given first.



Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app