PSA value of 11, but I have a UTI.

[LosLobo]

  On 11/19/2022 at 2:28 AM, lopburi3 said:

Note price is very important to some.  Cipo is often the cheapest broad spectrum antibiotic (was designed to be held as last resort for biological warfare) and even some doctors prescribe with no valid reason.  This is the only drug I am sure have extreme issues with - would not recommend for anyone as anything but last resort and only after they read up on possible side effects.  

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I developed peripheral neuropathy shortly after taking a prescribed course of Norfloxacin a fluoroquinolone.

 

"Fluoroquinolone antibiotics and risk of aortic aneurysm/dissection" and "Central Nervous System Effects".

 

Update - fluoroquinolone antibiotics and adverse events | Therapeutic Goods Administration (TGA)

 

"Ultimately, the risk of peripheral neuropathy increased by an estimated 3% for each additional day of current fluoroquinolone exposure, maintained for up to 180 days post-exposure".

 

International Committee Proposes MS Disease Progression Framework Driven by Pathophysiological Mechanisms, Not Clinical Phenotype (neurologylive.com)

[Boyn]

  On 11/18/2022 at 11:27 AM, xylophone said:

Did they use the Da Vinci robotic machine to remove your prostate??

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Yes and because of that i was i hospital for only 1 night, but 2 months off work

[Sheryl]

  On 11/19/2022 at 2:36 AM, BritManToo said:

Penicillin is deadly to some people.

Just because something doesn't work for you is no reason for everyone to avoid it.

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He was not talking about allergy but about documented adverse effects that are serious enough - and common enough - that the US FDA added a "black box" warning.  Most patients are fine with it but more than a few suffer serious adverse effects. Especially older patients and people on the drug for prolonged periods.

 

Most Thai doctors seem not to have gotten the memo and continue to prescribe these like candy (same is true of the COX-2 inhibitors).

 

It is indeed sometimes necessary to use this class of drugs but should be done with special caution.

 

"Although most patients do not have problems, the FDA told doctors to consider the benefits and risks for each patient before prescribing a fluoroquinolone"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2483892/

[scubascuba3]

  On 11/19/2022 at 2:18 AM, BritManToo said:

Easily available at most pharmacies and recommended for UTIs.

Moved from Cipro 500 @100bht to Norfloxstar 400 @80bht.

 

STDs and UTIs are the same thing IMHO.

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Doxycycline worked for me when Azithromycin and ceftriaxone failed. Less than 100 baht for a weeks worth

[xylophone]

  On 11/19/2022 at 2:18 AM, BritManToo said:

STDs and UTIs are the same thing IMHO.

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For your perusal ........https://ada.com/editorial/uti-or-sti-how-to-spot-the-difference/

[BritManToo]

  On 11/19/2022 at 5:56 AM, xylophone said:

For your perusal ........https://ada.com/editorial/uti-or-sti-how-to-spot-the-difference/

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From that I've never had an STD, always UTIs.

 

[scubascuba3]

  On 11/19/2022 at 6:20 AM, BritManToo said:

From that I've never had an STD, always UTIs.

 

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The list should say, if you live in Thailand and a bit of a monger it's more likely it's an STI

[LosLobo]

  On 11/19/2022 at 6:20 AM, BritManToo said:

From that I've never had an STD, always UTIs.

 

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Did you have urine cultures for those " always UTIs" ?

[simon43]

Update:  I had my consultation with Dr Viroj at Bumrungrad today.  Despite a recent negative DRE at another well-known private hospital in 'Bangkok', Dr Viroj was able to feel a small growth inside my prostate.  That's encouraging (because with my high PSA I have already assumed that there is a growth..).  Next step is an MRI to more accurately locate that growth and then decide how to 'kill' the blighter.

[LosLobo]

  On 11/21/2022 at 8:39 AM, simon43 said:

Update:  I had my consultation with Dr Viroj at Bumrungrad today.  Despite a recent negative DRE at another well-known private hospital in 'Bangkok', Dr Viroj was able to feel a small growth inside my prostate.  That's encouraging (because with my high PSA I have already assumed that there is a growth..).  Next step is an MRI to more accurately locate that growth and then decide how to 'kill' the blighter.

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Expect the worst and you'll never be disappointed. I am not a medical professional, but I don't think feeling a small growth inside your prostate always means that it is cancer or something that needs to be killed. 

 

If after an MRI and a biopsy you find that you really have cancer it may not be a high Gleason score and may only need active surveillance and having cancer is not a sentence as I have found out.

 

Anyway, thank for sharing and Good Luck!

 

 

[xylophone]

  On 11/21/2022 at 8:39 AM, simon43 said:

Update:  I had my consultation with Dr Viroj at Bumrungrad today.  Despite a recent negative DRE at another well-known private hospital in 'Bangkok', Dr Viroj was able to feel a small growth inside my prostate.  That's encouraging (because with my high PSA I have already assumed that there is a growth..).  Next step is an MRI to more accurately locate that growth and then decide how to 'kill' the blighter.

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Not sure if this will be of use, but "Brachytherapy" has been used to good effect in the prostate. ATB.

[KannikaP]

  On 10/9/2022 at 12:57 AM, lopburi3 said:

Be pro active with that as could be serious (was for me) - perhaps ultrasound to examine bladder.  Mine was also after exercise but caused by cancer in bladder (which with earlier detection might have saved me the bladder etc).  

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Quit the exercise then!   555

[simon43]

  On 11/21/2022 at 9:59 AM, xylophone said:

Not sure if this will be of use, but "Brachytherapy" has been used to good effect in the prostate. ATB.

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Yes, I have been considering all options.  TBH, because of my BPH, which reduces my pee stream to a dribble (if I'm lucky), I'd rather have my prostate removed, thus solving both the BPH and cancer problems.  I'm aware of the effects of having no prostate (ED and temporary incontinence), but my wedding tackle has all but rusted up years ago through lack of use......

[xylophone]

  On 11/21/2022 at 10:31 AM, simon43 said:

Yes, I have been considering all options.  TBH, because of my BPH, which reduces my pee stream to a dribble (if I'm lucky), I'd rather have my prostate removed, thus solving both the BPH and cancer problems.  I'm aware of the effects of having no prostate (ED and temporary incontinence), but my wedding tackle has all but rusted up years ago through lack of use......

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Well Simon, you're a braver man than me (Gunga din!).

 

Although having said that, if I were to have a prostate removal, I would certainly opt for the Da Vinci robotic surgery machine as it is supposed to be the ultimate in "nerve sparing" surgery, which should mean that erectile dysfunction and incontinence are a thing of the past, however that all depends upon how widespread the cancer is and how good the operator is!

 

https://www.nature.com/articles/d41586-020-01037-w

[simon43]

  On 11/21/2022 at 10:47 AM, xylophone said:

Well Simon, you're a braver man than me (Gunga din!).

 

Although having said that, if I were to have a prostate removal, I would certainly opt for the Da Vinci robotic surgery machine as it is supposed to be the ultimate in "nerve sparing" surgery, which should mean that erectile dysfunction and incontinence are a thing of the past, however that all depends upon how widespread the cancer is and how good the operator is!

 

https://www.nature.com/articles/d41586-020-01037-w

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Yes, the multi-armed robot would be used in my case ????

[Sheryl]

Thanks for the update, Simon.I am relieved you are in good hands. Keep us posted.

[JimmyJ]

  On 11/21/2022 at 10:31 AM, simon43 said:

I'm aware of the effects of having no prostate (ED and temporary incontinence), but my wedding tackle has all but rusted up years ago through lack of use......

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"I'm aware of the effects of having no prostate (ED and temporary incontinence)..."

 

I thought it is ED and temporary or permanent incontinence.

[simon43]

  On 11/21/2022 at 11:33 AM, JimmyJ said:

"I'm aware of the effects of having no prostate (ED and temporary incontinence)..."

 

I thought it is ED and temporary or permanent incontinence.

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From what I have read (many citations), the ED and incontinence can be temporary.  It seems to depend on your own level of health and fitness.  I consider myself fit and healthy for my age (63 years old, 66Kg 50 bpm resting heart rate).  The ED makes no difference to me - I went off sex after my 3rd divorce.. The effects of urinary incontinence on your life will depend on your own circumstances.  I live alone and teach online, I can't see a big deal about this TBH.  Of course YMMV ????

[Adumbration]

Good luck Simon.  Please keep us updated.

[simon43]

[quote]

..

If after an MRI and a biopsy you find that you really have cancer it may not be a high Gleason score and may only need active surveillance and having cancer is not a sentence as I have found out.

[/quote]

 

Active surveillance is probably not an option because my PSA was high (6) but stable at that number for the past 10 years (high value maybe due to my enlarged prostate - BPH).  But now my PSA number has 'taken off', rising from 11.2 some 8 weeks ago to 14.5 last week. So it's not going in a good direction ????

[simon43]

By the way, I wanted to comment on the excellent service provided so far by Dr Viroj and the international insurance department at Bumrungrad Hospital.  Although I have an excellent 'expat' insurance policy, I was very concerned that I would either be required to pay 'up-front' for the major costs and claim back later, or I would have to do that for all the initial investigation tests (MRI, biopsy etc).  I explained to their insurance department that my parlous financial situation as a poor teacher with 3 ex-wives meant that it would be a big problem for me if I had to pay out and then claim back.

 

Both doctor and insurance officer were very understanding and agreed to request April Insurance to agree for direct billing of 'the lot' >> all pre-operation tests/investigation costs, rather than for me to pay and then claim back.  Dr Viroj specifically wrote on his report to April that surgery/inpatient treatment would be needed, and therefore pre-authorisation for all MRI/biopsy work etc should be given by April.  (I hope April agree to this!).

 

Anyway, I was very happy with their attitude.  They even had my registration details from 15 years ago (advanced pneumonia), when all other private hospitals that I visited in Thailand seem to 'lose' my details after 5 years!

[Lorry]

  On 11/21/2022 at 2:52 PM, simon43 said:

They even had my registration details from 15 years ago (advanced pneumonia), when all other private hospitals that I visited in Thailand seem to 'lose' my details after 5 years!

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Some people are not so happy if hospitals remember too much too long.

I can lead to insurance problems. 

But yes, I was p issed  off when BNH didn't remember my HN from 2542 recently.  

[scubascuba3]

  On 11/21/2022 at 2:52 PM, simon43 said:

By the way, I wanted to comment on the excellent service provided so far by Dr Viroj and the international insurance department at Bumrungrad Hospital.  Although I have an excellent 'expat' insurance policy, I was very concerned that I would either be required to pay 'up-front' for the major costs and claim back later, or I would have to do that for all the initial investigation tests (MRI, biopsy etc).  I explained to their insurance department that my parlous financial situation as a poor teacher with 3 ex-wives meant that it would be a big problem for me if I had to pay out and then claim back.

 

Both doctor and insurance officer were very understanding and agreed to request April Insurance to agree for direct billing of 'the lot' >> all pre-operation tests/investigation costs, rather than for me to pay and then claim back.  Dr Viroj specifically wrote on his report to April that surgery/inpatient treatment would be needed, and therefore pre-authorisation for all MRI/biopsy work etc should be given by April.  (I hope April agree to this!).

 

Anyway, I was very happy with their attitude.  They even had my registration details from 15 years ago (advanced pneumonia), when all other private hospitals that I visited in Thailand seem to 'lose' my details after 5 years!

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Just to confirm, you've got the April International (France) insurance? not the Thai version? Good to hear good claim news

[simon43]

  On 11/21/2022 at 10:12 PM, scubascuba3 said:

Just to confirm, you've got the April International (France) insurance? not the Thai version? Good to hear good claim news

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Yes the 'expat' version, not the Thai version.

[scubascuba3]

  On 11/21/2022 at 10:35 PM, simon43 said:

Yes the 'expat' version, not the Thai version.

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ok I'm assuming the "expat" version is April International as April Thailand is also for expats

[Sheryl]

  On 11/21/2022 at 10:43 PM, scubascuba3 said:

ok I'm assuming the "expat" version is April International as April Thailand is also for expats

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April Thailand (a Thai company, with a Thai underwriter; comes under Thai insurance regs) will insure both Thais and expats.

 

He means April Global, a French insurer which does their own underwriting and falls under EU regulations.

[simon43]

  On 11/22/2022 at 4:52 AM, Sheryl said:

April Thailand (a Thai company, with a Thai underwriter; comes under Thai insurance regs) will insure both Thais and expats.

 

He means April Global, a French insurer which does their own underwriting and falls under EU regulations.

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Yes, April Global, thanks for clarifying Sheryl.

[Adumbration]

  On 11/21/2022 at 2:52 PM, simon43 said:

By the way, I wanted to comment on the excellent service provided so far by Dr Viroj and the international insurance department at Bumrungrad Hospital.  Although I have an excellent 'expat' insurance policy, I was very concerned that I would either be required to pay 'up-front' for the major costs and claim back later, or I would have to do that for all the initial investigation tests (MRI, biopsy etc).  I explained to their insurance department that my parlous financial situation as a poor teacher with 3 ex-wives meant that it would be a big problem for me if I had to pay out and then claim back.

 

Both doctor and insurance officer were very understanding and agreed to request April Insurance to agree for direct billing of 'the lot' >> all pre-operation tests/investigation costs, rather than for me to pay and then claim back.  Dr Viroj specifically wrote on his report to April that surgery/inpatient treatment would be needed, and therefore pre-authorisation for all MRI/biopsy work etc should be given by April.  (I hope April agree to this!).

 

Anyway, I was very happy with their attitude.  They even had my registration details from 15 years ago (advanced pneumonia), when all other private hospitals that I visited in Thailand seem to 'lose' my details after 5 years!

Expand  

Thanks for the updates Simon.

 

Do you know what the relevant costs are?  Or have you not even bothered asking because you are insured.

 

And in Bumrungrad a private or government hospital?

 

Also what is the annual premium on your April insurance?

[Lorry]

  On 11/22/2022 at 3:34 PM, Adumbration said:

And in Bumrungrad a private or government hospital?

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Private.

About the most expensive you can find. 

[jerrymahoney]

  On 11/22/2022 at 4:52 AM, Sheryl said:

He means April Global, a French insurer which does their own underwriting and falls under EU regulations.

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Our plans are underwritten by either AXA XL Insurance Company UK Limited or AXA XL Underwriting -- page 8

 

https://uk.april-international.com/sites/united_kingdom/files/2022-04/Long-Term International Health Plan - Brochure.pdf