Hello Sheryl...Is there a decent urologist I can see at Vachira government hospital in Phuket

[Adumbration]

8 hours ago, Chainsaw said:

Wrong!  At approximately 2000 baht it is MUCH cheaper than the private hospitals. I've had check-ups at both and the Vachira clinic is by far the better deal. No ECG, PSA test or chest X-ray at Siriroj unless you pay extra, for example.

I was unaware of this new expansion of Vachira.  I speak fluent Thai and so I will do some research on their service offerings and pricing next time I am down in Phuket.

 

As I have already posted in this thread, Andalab, which is literally across the road from Vachira do a full check up package for 990 baht and it has been at that exact price for more than a decade so definitely good value.

 

If this new Vachira facility is offering services priced in between Government Vachira and Extortionate Bangkok Hospital prices that would be a clever move by them.  There are lots of well shod middle class Thais in Phuket that would certain pay to get away from the huge crowds at Vachira but whom would never consider paying the rip off prices at Bangkok Hospital.

[Sheryl]

A number of unhelpful and/or flaming posts have been removed along with some duplicative posts. 

[Adumbration]

Sheryl

 

Thanks for cleaning up this thread.

 

Although they still have it listed on their website, I arrived at Andalab early this morning with my urine sample only to find out they no longer have the Chlamidia antigen test available.  Their excuse was the are no test kits available....but I could of course have the multiplex PCR STI test for 3,800 baht.

 

I have dealt with this lab a bit over the years and they have been straight shooters in the past so I don't think they were lying and trying to upsell...but who knows TIT.

 

I told them they need to edit the available test list on their website to show they no longer offer Chlamidia Antigen tests.

 

There was also some confustion over my request to ensure my urine culture included sensitivity so I posted this for them to read on whatsapp:

 

Also called an antibiotic susceptibility test, this test identifies the type of bacteria causing the infection and which antibiotics the bacteria is sensitive to, meaning which antibiotics will kill the bacteria.

 

So the results for my urine culture will be ready early next week.

 

Should I try and also get Chlamidia antigen tests for my GF and I in the interim or do you think I should first wait for the results from my culture?

Edited August 29, 2022 by Adumbration

[Sheryl]

10 hours ago, Adumbration said:

Sheryl

 

Thanks for cleaning up this thread.

 

Although they still have it listed on their website, I arrived at Andalab early this morning with my urine sample only to find out they no longer have the Chlamidia antigen test available.  Their excuse was the are no test kits available....but I could of course have the multiplex PCR STI test for 3,800 baht.

 

I have dealt with this lab a bit over the years and they have been straight shooters in the past so I don't think they were lying and trying to upsell...but who knows TIT.

 

I told them they need to edit the available test list on their website to show they no longer offer Chlamidia Antigen tests.

 

There was also some confustion over my request to ensure my urine culture included sensitivity so I posted this for them to read on whatsapp:

 

Also called an antibiotic susceptibility test, this test identifies the type of bacteria causing the infection and which antibiotics the bacteria is sensitive to, meaning which antibiotics will kill the bacteria.

 

So the results for my urine culture will be ready early next week.

 

Should I try and also get Chlamidia antigen tests for my GF and I in the interim or do you think I should first wait for the results from my culture?

Since you already have urine culture pending may as wait for that first.

[Adumbration]

21 hours ago, Sheryl said:

Since you already have urine culture pending may as wait for that first.

Does Chlamidia show up in a urine culture?

[Sheryl]

6 hours ago, Adumbration said:

Does Chlamidia show up in a urine culture?

Sometimes.

 

Urethral swab  is more sensitive but it may show in a regular culture.

 

So if you are negative (both for chlamydia and anything else; remember, chlamydia is not the only thing that can cause either a UTI or prostatitis) then you  might want ti get an antigen test using urethral swab.

 

Actually the most accurate test is NAAT (similiar to a PCR) as it can detect minute quantities of the pathogen but that was nto on the list of the lab you plan to go to.

[Adumbration]

Thanks Sheryl. I will post back when my culture results are in.

[Adumbration]

Hello Sheryl

 

Urine cultures results just in:

 

Culture: Less than 10^3 CFU/ml  (No growth)

 

What should I do next?

 

Should I now get a PSA and CEA from the lab?

Edited September 2, 2022 by Adumbration

[Sheryl]

14 hours ago, Adumbration said:

Hello Sheryl

 

Urine cultures results just in:

 

Culture: Less than 10^3 CFU/ml  (No growth)

 

What should I do next?

 

Should I now get a PSA and CEA from the lab?

 

Do you still have burning on urination?

 

Either see a doctor now, or get a chlamydia test (antigen and blood tests) first and then see a doctor with the result. Do the antigen test with uretahral swab, more accurate than on urine.

 

If these tests are negative, getting a urine sample after prostate massage for culture will sometimes identify organisms not found on regular urine sample, so ask doctor about this.

 

If you have prostatitis, PSA will be elevated and the elevation doesn't tell much. If doctor, after examination, does not think it is prostatitis then yes PSA is useful. Otherwise wait until the inflammation resolves (unless doctor advises otherwise).

 

If he thinks it is prostatitis odds are doctor  will prescribe a course of a quinolone like levofloxacin.

 

CEA has no utility in diagnosis of either prostatitis, BPH or prostate cancer.

[Adumbration]

11 hours ago, Sheryl said:

 

Do you still have burning on urination?

 

Either see a doctor now, or get a chlamydia test (antigen and blood tests) first and then see a doctor with the result. Do the antigen test with uretahral swab, more accurate than on urine.

 

If these tests are negative, getting a urine sample after prostate massage for culture will sometimes identify organisms not found on regular urine sample, so ask doctor about this.

 

If you have prostatitis, PSA will be elevated and the elevation doesn't tell much. If doctor, after examination, does not think it is prostatitis then yes PSA is useful. Otherwise wait until the inflammation resolves (unless doctor advises otherwise).

 

If he thinks it is prostatitis odds are doctor  will prescribe a course of a quinolone like levofloxacin.

 

CEA has no utility in diagnosis of either prostatitis, BPH or prostate cancer.

Thanks very much Sheryl.  I will report back with my progress.

[Adumbration]

Hello Sheryl

 

I have finished a course of Doxycycline...morning and night for 28 days.

 

No longer have burning when I pee however still have dull pain in my urethra and below my testicles.

 

I have purchased Ciprofloxacin 500mg 10 sheets (100 capsules) so enough for 28 day treatment at 2 capsules per day.  But I have not yet started taking it.

 

You might recall from some of my other posts that I have Haemochromatosis and I know from genetic testing years ago that I am C282Y.

 

I read a new research paper this morning that concludes that male p.C282Y homozygotes have a 32% higher risk of developing prostate cancer so I am now quiet anxious:

 

https://www.medrxiv.org/content/10.1101/2022.02.28.22271621v1

 

I have a number of questions and I would be grateful for your kind input on each:

 

1. In the last month or so I have been burping after eating.  This is unusual because I have never had it before in my life.  Could it be linked to my prostrate problems?

 

2. Should I start the course of Cipro now?

 

3. What are the cheapest steps/ways to move forward to identify what the issue is with my prostate?  Due to cost, and also my distrust of Thai doctors, I would like to self manage anything that is possible.  As you already know I have access to AndaLab for blood and other tests.

 

4. Should I have prostate cancer, what are the usual steps for treatment and likely associated costs here in Thailand.

 

5. Do you think it would be more prudent to have any required surgeries and/or treatments here or return back to Australia (please note that I have no family whatsoever for support back there).

 

Thanks

 

 

Edited October 16, 2022 by Adumbration

[Sheryl]

1. No

 

2. No

 

3.See a good urologist. You have already likely spent more in your attempts to manage this on your own than was necessary. 

 

There are some excellent Western trained urologists in Bangkok if you are not comfortable with local options.

 

Treatment of prostate cancer is a complex subject and much depends on the size snd stage. Don't get ahead of yourself. 

 

 

 

[Dart12]

If your pee is still hurting, you more than likely have scarred your urethra is my guess.

Vocin 500 is good, it is mid tier, 2nd generation levofloxcin.  Should be able to get 5 for 250 or less.  do 5 days, if still have bladder pain, add an additional 5 day per my doctor.

If I were you, based on your symptoms, I would have gotten general test for your woman and both taken the STD shot.  7 days of doxy plux levofloxacin.

I like you have only my sexual partner , but kept getting it.  Turns out she had it, even though first doctor said she did not.  So I took her to my doc and it came to that she had bacteria.

And be careful with the doxazosin...that should be SLOWLY to the level you are taking right off the bat.  You can cause yourself a lot of problems if you don't build your bodies tolerance to that drug.

Goodluck.

[Adumbration]

2 hours ago, Dart12 said:

If your pee is still hurting, you more than likely have scarred your urethra is my guess.

Vocin 500 is good, it is mid tier, 2nd generation levofloxcin.  Should be able to get 5 for 250 or less.  do 5 days, if still have bladder pain, add an additional 5 day per my doctor.

If I were you, based on your symptoms, I would have gotten general test for your woman and both taken the STD shot.  7 days of doxy plux levofloxacin.

I like you have only my sexual partner , but kept getting it.  Turns out she had it, even though first doctor said she did not.  So I took her to my doc and it came to that she had bacteria.

And be careful with the doxazosin...that should be SLOWLY to the level you are taking right off the bat.  You can cause yourself a lot of problems if you don't build your bodies tolerance to that drug.

Goodluck.

Hello

 

Thanks for your input and your heads up on doxazasin.  I have been on that drug now for a month or more.  Intial doses a little giddyness, but that quickly subsided and no other notable side effects to date. As I reported above, it was a bit of a win for me moving to that drug.  I was taking blood pressure meds anyway and I have successfully substituted my prevous drug with doxa.  It definitely does help me pee.  Not a lot but it does help.  So I am handling two problems, BP and urination, with one drug (which is also cheaper than my other BP meds I was using).  I am taking Cardoxa 2mg and I take one pill with breakfast and then one pill before bed.  It is cheap.  I can buy a box of 10 sheets, 100 pills for 145 baht, so less than 3 baht per day on current dosage.

[Adumbration]

Was planning on getting a PSA done today, but totally flooded out in Phuket.

[Dart12]

5 minutes ago, Adumbration said:

Hello

 

Thanks for your input and your heads up on doxazasin.  I have been on that drug now for a month or more.  Intial doses a little giddyness, but that quickly subsided and no other notable side effects to date. As I reported above, it was a bit of a win for me moving to that drug.  I was taking blood pressure meds anyway and I have successfully substituted my prevous drug with doxa.  It definitely does help me pee.  Not a lot but it does help.  So I am handling two problems, BP and urination, with one drug (which is also cheaper than my other BP meds I was using).  I am taking Cardoxa 2mg and I take one pill with breakfast and then one pill before bed.  It is cheap.  I can buy a box of 10 sheets, 100 pills for 145 baht, so less than 3 baht per day on current dosage.

I mistook amount you taking.  Following someone else's protocol they shared here that helped them was. taking 3 daily  and 5mg finasteride every other day. I do not know his weight, which plays a part in dosage .  I"m not sure, but I think it requires long term usage for full effects.  

[Dart12]

8 minutes ago, Adumbration said:

Hello

 

 It is cheap.  I can buy a box of 10 sheets, 100 pills for 145 baht, so less than 3 baht per day on current dosage.

Where are you getting that, please?  I'd like order from your source.

[Adumbration]

16 minutes ago, Dart12 said:

Where are you getting that, please?  I'd like order from your source.

There is a bulk supermarket called SuperCheap in Phuket.  It is just across the road from the bus station on Thepkrassatri road.  It is a huge store.  At the back they have a big pharmacy that sells drugs at wholesale prices.  I buy them in person not online.

[Sheryl]

52 minutes ago, Adumbration said:

Was planning on getting a PSA done today, but totally flooded out in Phuket.

Make sure to have no sexual activity or bike/moto riding for 48 hrs before PSA test 

[Dart12]

1 hour ago, Adumbration said:

There is a bulk supermarket called SuperCheap in Phuket.  It is just across the road from the bus station on Thepkrassatri road.  It is a huge store.  At the back they have a big pharmacy that sells drugs at wholesale prices.  I buy them in person not online.

the store is called supercheap that sells the drugs?  I am much too far to visit.  But prices here for that box is 750

[Adumbration]

7 hours ago, Sheryl said:

Make sure to have no sexual activity or bike/moto riding for 48 hrs before PSA test 

Thanks for the tip.  The motorbike riding is an issue because it is my only transport option at the moment.  It is about 15 minute ride, maybe I can put a pillow on my scooter seat??

 

Quoted price from Andalab for the PSA was 750 baht.  

Edited October 17, 2022 by Adumbration