Advice needed re Circumcision

[howerde]

2 minutes ago, Lacessit said:

There is no such thing as good rice, it is still high carbohydrate. As are all grains.

 

Forget the glycemic index, this is the diet that got me from 93 kg to 78 kg, and reduced my hbA1C  to non-diabetic levels. I eat until full.

 

1/ Meat of any description. Eggs.

2/ Vegetables - broccoli, green beans, cauliflower, cabbage, tomato.

3/ Fruit - strawberry, blueberry, apple.

4/ Almonds

5/ Dairy - cheese and yoghurt, unsweetened. Skim milk is not diet, it is actually rich in lactose.

 

NO processed foods. NO sugar. NOTHING that grows underground.

If your partner must drink alcohol, spirits such as whisky and rum only.

 

 

 

That advice might be good for a westerner but

His partner is Thai, there is no way he is going to eat a diet like that, Thai giving up rice is not going to happen, you have to work with what you can buy easily and importantly you like and can eat, forcing yourself to eat food you do not like will mean you give up.

Monitoring you GI index is they way to go if you want to eat a balanced diet with different food and not stuck on some restrictive diet eating the same meals day after day.

I Was told my blood sugar level was 214mg/dl and an hba1c level of about 9.5  2/12 years ago.  i cook my own food i never add sugar/salt but i can eat everything i like including rice, pasta. i  am not on any medication for the last 8 months, on my last hospital visit my sugar was 86 mg/dl and hba1c 5.0 all my ldl levels were fine, and as important as diet so is exercise, i cycle at least 8-10 km a day well 5 days a week as a bonus my blood pressure is way down it was usually near the top of the medium range

[Lacessit]

1 minute ago, howerde said:

That advice might be good for a westerner but

His partner is Thai, there is no way he is going to eat a diet like that, Thai giving up rice is not going to happen, you have to work with what you can buy easily and importantly you like and can eat, forcing yourself to eat food you do not like will mean you give up.

Monitoring you GI index is they way to go if you want to eat a balanced diet with different food and not stuck on some restrictive diet eating the same meals day after day.

I Was told my blood sugar level was 214mg/dl and an hba1c level of about 9.5  2/12 years ago.  i cook my own food i never add sugar/salt but i can eat everything i like including rice, pasta. i  am not on any medication for the last 8 months, on my last hospital visit my sugar was 86 mg/dl and hba1c 5.0 all my ldl levels were fine, and as important as diet so is exercise, i cycle at least 8-10 km a day well 5 days a week as a bonus my blood pressure is way down it was usually near the top of the medium range

Valid point concerning Thais. It's like Vegemite for Australians, we are brought up on it.

You can add salt to taste, there is no peer-reviewed research showing normal salt levels do anything to elevate blood pressure.

I don't regard my diet as restrictive. There are plenty of variations, such as multiple types of cheeses. I also vary the spices accompanying the food.

I agree exercise is important as complementary to diet.

 

[connda]

40 minutes ago, Lacessit said:

There is no such thing as good rice, it is still high carbohydrate. As are all grains.

 

Forget the glycemic index, this is the diet that got me from 93 kg to 78 kg, and reduced my hbA1C  to non-diabetic levels. I eat until full.

 

1/ Meat of any description. Eggs.

2/ Vegetables - broccoli, green beans, cauliflower, cabbage, tomato.

3/ Fruit - strawberry, blueberry, apple.

4/ Almonds

5/ Dairy - cheese and yoghurt, unsweetened. Skim milk is not diet, it is actually rich in lactose.

 

NO processed foods. NO sugar. NOTHING that grows underground.

If your partner must drink alcohol, spirits such as whisky and rum only.

 

 

 

Which is Keto.

[connda]

12 minutes ago, Lacessit said:

His partner is Thai, there is no way he is going to eat a diet like that, Thai giving up rice is not going to happen

Then his partner will slowly die.....

[watthong]

7 hours ago, connda said:

Buy some gauze and cut it in lengths.  Wrap around the shaft below the head and then pull the foreskin over it (sorry for the graphic description but?).  Do this three or four times a day or if the gauze gets damp or wet. He just needs to wick the dampness away so the skin isn't a breeding ground for bacteria.  Have him wash his friend with Betadine (Iodine/Provolone solution) in-between dressings.  Have him save himself the pain and money.  Speaking from about 45 years of experience.

Caveat - I'm not a medical expert and this is nothing but my personal anecdotal advice.  Always consult a doctor. 

 

Will try your "gauze/betadine" treatment as a stop-gap measure while  getting things under control (doctor, diet, etc.) One thing is that lately we have started going swimming for exercise. Should my partner stop that for now - I'm thinking of the chlorine in the pool water?

[watthong]

6 hours ago, Lacessit said:

Forget the glycemic index, this is the diet that got me from 93 kg to 78 kg, and reduced my hbA1C  to non-diabetic levels. I eat until full.

 

1/ Meat of any description. Eggs.

2/ Vegetables - broccoli, green beans, cauliflower, cabbage, tomato.

3/ Fruit - strawberry, blueberry, apple.

4/ Almonds

5/ Dairy - cheese and yoghurt, unsweetened. Skim milk is not diet, it is actually rich in lactose.

 

NO processed foods. NO sugar. NOTHING that grows underground.

If your partner must drink alcohol, spirits such as whisky and rum only.

Will try this diet 1st thing. Fortunately we don't consume alcohol.

[watthong]

6 hours ago, howerde said:

That advice might be good for a westerner but

His partner is Thai, there is no way he is going to eat a diet like that, Thai giving up rice is not going to happen, you have to work with what you can buy easily and importantly you like and can eat, forcing yourself to eat food you do not like will mean you give up.

Monitoring you GI index is they way to go if you want to eat a balanced diet with different food and not stuck on some restrictive diet eating the same meals day after day.

I Was told my blood sugar level was 214mg/dl and an hba1c level of about 9.5  2/12 years ago.  i cook my own food i never add sugar/salt but i can eat everything i like including rice, pasta. i  am not on any medication for the last 8 months, on my last hospital visit my sugar was 86 mg/dl and hba1c 5.0 all my ldl levels were fine, and as important as diet so is exercise, i cycle at least 8-10 km a day well 5 days a week as a bonus my blood pressure is way down it was usually near the top of the medium range

He has volunteered to give up rice and noodles. Also sweets (cake, khanom thai, etc.) Plus real sweet fruits, such as mango (maybe I should cross out papaya and guava as well). Right now we try to eat the not so sweet fruit, but still not sure whether that means anything?

[watthong]

7 hours ago, connda said:

He and his partner seriously need to consult a medical specialist about his diabetes.  From what I'm reading, neither have a clue regarding how to manage diabetes. 
Just went back to see if this was post number 1 on AN.  But its not so the OPs been around.

OP - take your partner and go see a diabetes specialist. 

Totally on point. He does not have a primary doctor. Every 3 months or whenever his blood pressure/diabetes pills run out he would go to the neighborhood clinic (in Odum Suk) and be seen by which ever doctor on hand that day. He would have an "insulin" mini crisis now and then when out and about and suddenly he would need to eat something (sweet or not) real fast and we just rush to the nearest 7-11 to grab it. I know that seemed rather precarious but he's a big guy and we just thought he would need to eat more often (than someone average like me.)

[scorecard]

8 hours ago, scubascuba3 said:

Diet change can reverse diabetes type 2, most people lack the willpower for that and just do drugs and keep stuffing their faces.

 

As for circumcision, not easy in adulthood I've read, depends on person, more a mental thing

Keep in mind that a very large % of Pinoy men are circumcised but it happens in very late ten years.

 

Unfortunately the quality of the work occupies a big range. Some are circumcised so that there's no flabby skin remaining and some are the opposite.

 

Also some are cicumcised by the local unqualified popular auntie on the kitchen table whos has done it before an often left a mess, which is allowed, and some are circumcised by properly qualified well experienced surgeons.

[watthong]

7 hours ago, scubascuba3 said:

He needs to find out, then he knows what he's dealing with.

 

This video maybe of help, skip to 22 minutes onwards

 

https://youtu.be/BvkRtCFLmK0

Yes, and yes and yes. In a way we've been kinda ignoring the elephant in the room and he would rely on pills rather than change diet (see my other posts before this one). But now the problem has reached the critical so it's do it or die time he feels, which is a good start. Will report back after taking a good look at the video.

Edited July 28, 2023 by watthong

[watthong]

9 minutes ago, scorecard said:

Unfortunately the quality of the work occupies a big range. Some are circumcised so that there's no flabby skin remaining and some are the opposite.

 

I only know that in the states circumcision is a rather mundane routine so there wasn't much debate about it. But we're not in Kansas anymore...

[Ben Zioner]

9 hours ago, Celsius said:

What a strange way to deal with diabetes 

He  doesn't want to deal with diabetes, he wants to control on of the side effects...

 

This is a promising thread though...

 

But as many of us would know; circumcision is something you just get done as early as possible .

[watthong]

Just now, Ben Zioner said:

He  doesn't want to deal with diabetes, he wants to control on of the side effects...

Again another wild assumption. Let me repeat, if you have something helpful to say, please do so. Otherwise stop judging people when they are in extremis.  Have some tact.

[Lorry]

12 hours ago, watthong said:

My partner's diabetes has gotten to the level when his urine is now affecting his foreskin. Anyway it has begun to act up, small tears, skin thinning, itching, constricting etc. Looks like a circumcision is in order. We googled for info and this one Petcharavej Hospital came up, promoting the "Staple Circumcision" technique (a 10-15 min procedure, stitches-less.) Any advice on the prices or suggestion of other places? (We're in BKK). It's interesting that the cost for children is a lot more than for adults (28K to 35K vs 11k). Additional cost are 1k for pre-op consultation, 1k for covid test before surgery and 1k follow-up. 

 

[Also prior to posting this I searched "circumcision" on ASEAN forum and it came up with one single thread which debated mostly about the religious aspect of this practice, so please spare me that. My partner might need to resort to this for purely medical reason.] Thank you in advance for any helpful input.

 

https://www.petcharavejhospital.com/en/Package/package_detail/Staple-Circumcision-bestprice#:~:text=Staple Circumcision (Children) 35%2C000 Baht,Doctor fees

14k for adult circumcision at a hospital like Petcharavej is expensive.

That's a price I would expect at the international hospitals.

[Sheryl]

1. As others have said your partner needs to see a diabetes specialist. Most goverment hospitals have a diabetes clinic.

 

2. He also needs to consult a urologist about his foreskin problems. Depending on what the underlying cause is, surgery may or may not be indicated (and his diabetes may of may not be a factor). Note that when surgery  is indicated, there are often alternatives to full circumcision e.g. frenuloplasty or a "partial circumsion" .

 

There is no substitute for a proper urology consultation.

 

Is your partner registered at a government hospital under either Social Security or the"30 baht" scheme? As it should be possible to get whatever treatment is needed free of charge.

 

 

[whereyougo]

Carnivore diet best for diabetes and easy to follow. Cook meat and eat. He also may have a simple yeast infection that can be hard to shake if eating a lot of fruit or anything with sugar 

[Celsius]

19 hours ago, howerde said:

Yes mango and Durian should be avoided, you can eat plenty of guava and avocado

 

Those "smoothie" drinks always loaded with syrup. Never will I get one here in Thailand and never will I eat junk Thai food from the street.

 

 

 

Edited July 29, 2023 by Celsius

[Celsius]

20 hours ago, watthong said:

Limb amputation is also "a strange way to deal with diabetes."

 

Another strange comment. Mind boggling. They did this to my grandfather 40 years ago, but this was a 4th world country. He was also a holocaust survivor and was basically starving for years even after the war was over.

 

There is a lot of knowledge and a lot more ways to manage diabetes in 21st century. I am struggling with stomach issues myself and have to watch what I heat. Your partner obviously does not want to give up the "yummy" and another issue may be the lack of proper educated doctors if you don't live in a proper city.

 

 

 

 

[watthong]

17 minutes ago, Celsius said:

Another strange comment. Mind boggling.

This the reason why navigating forum conversation could become such a tiring affair. It didn't need to be so. My "limb amputation" was means as sarcasm to your citing circumcision as a "strange way of dealing with diabetes." But unlike spaghetti, sarcasm doesn't always stick to wherever you aim. My point is, nothing is strange when it comes to life saving solution, as Jingthing has pointed out. Amputating the lady leg when it got stuck in the airport walkway is definitely a strange way to get her out of it, but it seemed the only way at that juncture.

 

'Your partner obviously does not want to give up the "yummy" and another issue may be the lack of proper educated doctors if you don't live in a proper city.' This is correct, partner does/did not want to give up the yummy and he has an indulgent partner in myself so that's a tragedy. Re doctors, the clinic he goes to for physical health is the kind of hole-in-the wall neighborhood clinic when the caliber of physicians are not the choice kind. But it's cheap and generous with prescriptions. That's in itself is another tragedy <mild sarcasm>.

[Gaccha]

Your partner has to be persuaded to take it more seriously. The possibility of future limb amputation and blindness should hopefully wake him up.

 

Start with this nice, clean NHS explanation.

[watthong]

13 minutes ago, Gaccha said:

Your partner has to be persuaded to take it more seriously. The possibility of future limb amputation and blindness should hopefully wake him up.

 

Start with this nice, clean NHS explanation.

Absolutely. I myself should know better. My dad died of kidney (and whatever else organ) failures, complications which could be detected back to his long-term diabetes. The old man was stubborn and unfortunately I was not near him to take matter into my own hands. Now I have another family member seemingly on the same destructive path. I've been indulgent to my partner, who is also of the stubborn kind, so we had let the matter slide until we can't deny it any longer.

[watthong]

9 hours ago, Sheryl said:

Is your partner registered at a government hospital under either Social Security or the"30 baht" scheme? As it should be possible to get whatever treatment is needed free of charge.

Thanks SheryL for your helpful advice and info, as always. Yes he's got the "30 baht" scheme. We are thinking of going to the big hospital "Ramathibodi" near Victory Monument (bkk) first thing after the holidays. Unfortunately we are at the start of the 6 day holidays affair so it doesn't look like good time to go during this period.

[watthong]

21 hours ago, scubascuba3 said:

Diet change can reverse diabetes type 2, most people lack the willpower for that and just do drugs and keep stuffing their faces.

Yeah, that's more or less my partner's behavior, despite having me as a proponent of healthy eating/living. Anything that is flavorful to my farang palate is totally flavorless to his Thai one, thus piling on the sauce and the fat.

 

But he's wakened up to the facts now, and that's a good start. Glad to hear that even with type 2 (truth be told, I'm still in the dark of how many levels of diabetes there are...) you can still get out of. We go see specialists 1st thing after the holidays (see my reply to SheryL above.)

[watthong]

11 hours ago, Lorry said:

14k for adult circumcision at a hospital like Petcharavej is expensive.

That's a price I would expect at the international hospitals.

Thanks for the input. After reading many others, I'm now hoping we won't have to go down this route.

[watthong]

20 hours ago, howerde said:

How often is his blood tested daily? with a kit or every few months? he should have or should have been given an HbA1c test this would show his sugar level over 2-3 months, and regular monitoring

None daily. No home use kits, we so far had nothing, even an occasional "insulin" crisis only had us rush to the nearest 7-11 for something to tide him over and that's it. In short we were in denial regarding the gravity of diabetes.

[watthong]

I just want to send out a heartfelt thanks to everyone who has put in helpful advice and enlightened me in the process about diabetes. As mentioned earlier, my dad was a diabetes sufferer as well and because I was providing him care over long-distance, the effects did not really stick to my memories, but that was over 20 years ago and just like with accounting, something you have learned summarily but didn't have much practice with, you end up kinda forgetting about the abc of it as time goes by.

 

My partner being Thai, benefits from the "30 baht health care scheme." But since I'm now involved with direct care over his predicament, we will go the "after-hour" visiting route and hope will be seen by the more experienced physicians.

[watthong]

On 7/28/2023 at 2:36 PM, Lacessit said:

 

5/ Dairy - cheese and yoghurt, unsweetened. Skim milk is not diet, it is actually rich in lactose.

 

NO processed foods. NO sugar. NOTHING that grows underground.

One question regarding dairy. So you ate dairy product but not milk (fat or nonfat)? My guy drinks lot of full fat milk, hardest thing to weane him off, even above rice. He would give up rice but not milk.

[Lacessit]

2 hours ago, watthong said:

One question regarding dairy. So you ate dairy product but not milk (fat or nonfat)? My guy drinks lot of full fat milk, hardest thing to weane him off, even above rice. He would give up rice but not milk.

Milk is protein, fat, and sugar. Skim or low fat milk is actually worse, because it concentrates the sugar ( lactose ) more. Believe it or not, he is better off with cream.

I have a small amount of milk in tea or coffee. I eat as much cheese and yoghurt ( no added sugar ) as I want to.

If the body is starved of sugar, it will burn fat for energy instead.