General practitioner sought in Chiang Mai

[bamboozled]

Well heck, I don't know. I guess I didn't get that test. Hmm, I will be getting some tests I think about the end of the month, if not before, and will be sure to ask about that one. Thanks so much!

 

I just looked up the symptoms and I could have many of them but it's too subjective to make any conclusions. Who doesn't have itchy skin, gets up to pee, is tired, etc....?

Edited November 7, 2023 by bamboozled

[33 RPM]

It seems the "recommended " clinics are all west = south

any experiences , recommended medical clinic east of town

im in the Doi Saket area and would like to find a good general doctor out this way

[bamboozled]

6 hours ago, Mike Lister said:

A1C is a blood test.

Hey Mike,

 

I'm reading that the FBS test I had (fasting blood sugar) is now the go-to for diabetes testing and is more accurate than the A1C. WEll, that's what the internet told me. So, I guess I WAS tested for diabetes and it was negative. Darn, thought we were on to something! Thanks for your help!

[Mike Lister]

48 minutes ago, bamboozled said:

Hey Mike,

 

I'm reading that the FBS test I had (fasting blood sugar) is now the go-to for diabetes testing and is more accurate than the A1C. WEll, that's what the internet told me. So, I guess I WAS tested for diabetes and it was negative. Darn, thought we were on to something! Thanks for your help!

The FBS gives a single measurement reading at the time the test was taken and that's all, blood sugar spikes and drops throughout the day and night so no two readings are likely to be the same. The Dawn Phenomenon is where blood sugar readings spike first thing in the morning, before a person has eaten, that spike doesn't mean the person is diabetic necessarily.

 

It is not even remotely likely that a single FBS reading can confirm or rule out diabetes, it just isn't possible. The HbA1c test measures glycated red blood cells that have a life of 90 days. Sugar in the blood attaches to the blood cells hence measuring the volume of them determines blood sugar levels over 90 days, not just the one second the blood sample was taken.

 

You need to do some more reading, the FBS is not what you think it is.

[Lacessit]

Did your blood testing include haematology? There are about 16 parameters in it, including variables such as white blood cell count, neutrophils, haemoglobin etc. Worthwhile checking for any abnormality.

[bamboozled]

9 hours ago, Mike Lister said:

The FBS gives a single measurement reading at the time the test was taken and that's all, blood sugar spikes and drops throughout the day and night so no two readings are likely to be the same. The Dawn Phenomenon is where blood sugar readings spike first thing in the morning, before a person has eaten, that spike doesn't mean the person is diabetic necessarily.

 

It is not even remotely likely that a single FBS reading can confirm or rule out diabetes, it just isn't possible. The HbA1c test measures glycated red blood cells that have a life of 90 days. Sugar in the blood attaches to the blood cells hence measuring the volume of them determines blood sugar levels over 90 days, not just the one second the blood sample was taken.

 

You need to do some more reading, the FBS is not what you think it is.

Googling it again, it's a bit confusing, true. I'll do some more reading and get the test along with some others. I wonder why they do the FBS test and not the A1C? Probably cheaper. My sister, who has Hashimoto's disease, had me looking at the thyroid tests I've had over the past 3 years. One of the levels is close to the upper register and has been. No doctor flagged it but I'm going to point that out and get another test. Maybe I have hypothyroidism which would account for some of my symptoms.

[bamboozled]

9 hours ago, Lacessit said:

Did your blood testing include haematology? There are about 16 parameters in it, including variables such as white blood cell count, neutrophils, haemoglobin etc. Worthwhile checking for any abnormality.

It did include white blood cell and hemoglobin and some others, too. Just counting: 15 different tests. Hmm, my WBC was just over the minimum level. I've been confused about that one a bit. If you have high WBC, it shows you might have an infection. But low and you might GET an infection. And fatigue I'm reading. I'll have to check it again. Thanks for the input.

[Mike Lister]

5 minutes ago, bamboozled said:

Googling it again, it's a bit confusing, true. I'll do some more reading and get the test along with some others. I wonder why they do the FBS test and not the A1C? Probably cheaper. My sister, who has Hashimoto's disease, had me looking at the thyroid tests I've had over the past 3 years. One of the levels is close to the upper register and has been. No doctor flagged it but I'm going to point that out and get another test. Maybe I have hypothyroidism which would account for some of my symptoms.

As you say, the FBS is a quick and inexpensive test that can be a pointer towards needing to do the A1C, if it comes in very high or very low. If an FBS test comes in at 130 after fasting for nine hours, that's a pretty good indicator of the need to do an A1C, quickly. But if it comes in at say 105 in the morning, that's not conclusive of anything.

 

I'm getting ready to have my thyroid removed in ten days time so I can confirm thyroid tests are an important part of any blood test series. It is important to monitor TSH levels  and also free T4 to make sure they are in range. But it's equally as important to monitor those results over time and watch whether they rise or fall because that can be an indicator. My TSH levels were falling which is a sign of an enlarged thyroid which can be indicative of follicular tumors which may or may not be benign. Even though the result is still in range, the fact the numbers are falling is a red flag. Fortunately, most thyroid cancers are slow growing so there is time to react, but only if you test and track. 

[bamboozled]

11 minutes ago, Mike Lister said:

As you say, the FBS is a quick and inexpensive test that can be a pointer towards needing to do the A1C, if it comes in very high or very low. If an FBS test comes in at 130 after fasting for nine hours, that's a pretty good indicator of the need to do an A1C, quickly. But if it comes in at say 105 in the morning, that's not conclusive of anything.

 

I'm getting ready to have my thyroid removed in ten days time so I can confirm thyroid tests are an important part of any blood test series. It is important to monitor TSH levels  and also free T4 to make sure they are in range. But it's equally as important to monitor those results over time and watch whether they rise or fall because that can be an indicator. My TSH levels were falling which is a sign of an enlarged thyroid which can be indicative of follicular tumors which may or may not be benign. Even though the result is still in range, the fact the numbers are falling is a red flag. Fortunately, most thyroid cancers are slow growing so there is time to react, but only if you test and track. 

I wish you well on the surgery...unpleasant to say the least. My TSH is 3.924. which is almost the top of the accepted level. It's up a little bit from 3 years ago when it was 3.49. Certainly, I'm no doctor but I will bring it up with one. ...Hard to get any personalized care/discerning care especially with nebulous ailments like, "Oh, I'm tired/oh, I'm achy", etc... Or test results that fall within the accepted range but nonetheless might be out of whack for me or you. My FBS was 86 which seems fine but...

[Mike Lister]

25 minutes ago, bamboozled said:

I wish you well on the surgery...unpleasant to say the least. My TSH is 3.924. which is almost the top of the accepted level. It's up a little bit from 3 years ago when it was 3.49. Certainly, I'm no doctor but I will bring it up with one. ...Hard to get any personalized care/discerning care especially with nebulous ailments like, "Oh, I'm tired/oh, I'm achy", etc... Or test results that fall within the accepted range but nonetheless might be out of whack for me or you. My FBS was 86 which seems fine but...

My experience is that family doctors here are fine for the routine stuff and the first look at anything that doesn't appear serious but after that, go see a specialist and cut the GP out of your loop. If you have thyroid related concerns, my advice is to go to Sriphat and see Ass. Prof Dr Ampica who consults on Tuesday and Sunday for a few hours each day. She is widely regarded as the foremost endocrinologist in the North and is a lovely lady. A consultation will set you back 700 baht and will be worth every satang. I suggest that TSH at that point in the range, may need an expert opinion.

[bamboozled]

3 minutes ago, Mike Lister said:

My experience is that family doctors here are fine for the routine stuff and the first look at anything that doesn't appear serious but after that, go see a specialist and cut the GP out of your loop. If you have thyroid related concerns, my advice is to go to Sriphat and see Ass. Prof Dr Ampica who consults on Tuesday and Sunday for a few hours each day. She is widely regarded as the foremost endocrinologist in the North and is a lovely lady. A consultation will set you back 700 baht and will be worth every satang. I suggest that TSH at that point in the range, may need an expert opinion.

This is gold, Mike, thanks. Chatting with my sis last night, she pushed me toward finding an endocrinologist as well but I didn't know where to start and honestly I was getting bogged down mentally with all the things that might or might not be "wrong" with me. If she's only there on Tues. and Sun. she must have a clinic somewhere? I've always shied away from Sriphat because of the massive crowds. Plus it's a confusing space. I will search her out. Can one make an appointment, do you know?

[Mike Lister]

3 minutes ago, bamboozled said:

This is gold, Mike, thanks. Chatting with my sis last night, she pushed me toward finding an endocrinologist as well but I didn't know where to start and honestly I was getting bogged down mentally with all the things that might or might not be "wrong" with me. If she's only there on Tues. and Sun. she must have a clinic somewhere? I've always shied away from Sriphat because of the massive crowds. Plus it's a confusing space. I will search her out. Can one make an appointment, do you know?

There is a new Sriphat building that has been in place for a few years, it is completely unlike the old Sriphat building. There are no queues and there is no waiting. Dr Ampica does not have her own clinic as far as I know, she is semi retired, her details and hours are here: https://sriphat.med.cmu.ac.th/en/doctor/detail/124

 

The new building is located here: https://sriphat.med.cmu.ac.th/en/contact It is a multi floor high rise and Dr Ampica is on the 2nd floor. The building is located some distance West of the old one and is signposted as Sriphat OPD..

[bamboozled]

5 minutes ago, Mike Lister said:

There is a new Sriphat building that has been in place for a few years, it is completely unlike the old Sriphat building. There are no queues and there is no waiting. Dr Ampica does not have her own clinic as far as I know, she is semi retired, her details and hours are here: https://sriphat.med.cmu.ac.th/en/doctor/detail/124

 

The new building is located here: https://sriphat.med.cmu.ac.th/en/contact It is a multi floor high rise and Dr Ampica is on the 2nd floor. The building is located some distance West of the old one and is signposted as Sriphat OPD..

Much gratitude, Mike. I've noted that building in passing and happy to read your post about the much easier usage. I'll be there on Sunday or Tuesday, for sure. Thank you!

[bamboozled]

I'm told Dr. Ampica's schedule is full. I'm waiting to hear back from them about who can see me in her place.

[bamboozled]

3 hours ago, Mike Lister said:

There is a new Sriphat building that has been in place for a few years, it is completely unlike the old Sriphat building. There are no queues and there is no waiting. Dr Ampica does not have her own clinic as far as I know, she is semi retired, her details and hours are here: https://sriphat.med.cmu.ac.th/en/doctor/detail/124

 

The new building is located here: https://sriphat.med.cmu.ac.th/en/contact It is a multi floor high rise and Dr Ampica is on the 2nd floor. The building is located some distance West of the old one and is signposted as Sriphat OPD..

They ended up giving me an appointment with Dr. Ampica this coming Sunday!

[Mike Lister]

5 minutes ago, bamboozled said:

They ended up giving me an appointment with Dr. Ampica this coming Sunday!

Outstanding....PM to follow.

[bamboozled]

On 11/8/2023 at 12:29 PM, Mike Lister said:

Outstanding....PM to follow.

Saw Dr. Ampica and gave a blood sample for a new thyroid test. I have had 3 in the past 3 years and noticed my TSH level has been going up, even though not officially over the limit, but perhaps we're onto something. I go back tomorrow for the results. I forgot to mention the diabetes idea to her but will bring it up tomorrow. The hospital was pretty crowded but certainly much better organized than my previous experiences in the building on Suthep Rd. Dr. Ampica has a calming presence.

[Mike Lister]

1 minute ago, bamboozled said:

Saw Dr. Ampica and gave a blood sample for a new thyroid test. I have had 3 in the past 3 years and noticed my TSH level has been going up, even though not officially over the limit, but perhaps we're onto something. I go back tomorrow for the results. I forgot to mention the diabetes idea to her but will bring it up tomorrow. The hospital was pretty crowded but certainly much better organized than my previous experiences in the building on Suthep Rd. Dr. Ampica has a calming presence.

Yes, weekends can be busy, I try to go midweek.

 

I'm very happy to hear that, well done. Yes, Dr Ampica is a rare find. Years ago, shortly after I first met her she was treating me for higher than normal blood sugar. I'd made the connection between my condition and something known as metabolic syndrome which turned out to be correct. Empowered by the fact she had agreed with me, I went on to make a connection between metabolic syndrome and B12 deficiency and drew a diagram to explain it!!! She very graciously tolerated my ramblings which were completely wrong and she said something like, well we'll see later if you need a B12 shot or not, smiled and moved on. We became good friends immediately after but she does occasionally prod me about needing a B12 shot, in a good natured way, bless her.

[bamboozled]

3 hours ago, Mike Lister said:

Yes, weekends can be busy, I try to go midweek.

 

I'm very happy to hear that, well done. Yes, Dr Ampica is a rare find. Years ago, shortly after I first met her she was treating me for higher than normal blood sugar. I'd made the connection between my condition and something known as metabolic syndrome which turned out to be correct. Empowered by the fact she had agreed with me, I went on to make a connection between metabolic syndrome and B12 deficiency and drew a diagram to explain it!!! She very graciously tolerated my ramblings which were completely wrong and she said something like, well we'll see later if you need a B12 shot or not, smiled and moved on. We became good friends immediately after but she does occasionally prod me about needing a B12 shot, in a good natured way, bless her.

Ha! Your story makes me smile. I, too, play internet doctor yet try to be mindful and respectful when putting forth my ideas. I ran through them a bit yesterday and then put myself in her hands. In fact, going off on my thyroid tangent caused me to forget to ask about the diabetes. I would have added that test at the same time. Oh well...

 

I was worried a bit that with the hospital being so crowded she would be rushed. She didn't seem to be, though, thankfully.

 

B12 shots....I give them to myself as I'm deficient (not just mentally). It's simple and cheap. Haven't died or had a limb rot and fall off yet.

[bamboozled]

On 11/13/2023 at 9:07 AM, Mike Lister said:

Yes, weekends can be busy, I try to go midweek.

 

I'm very happy to hear that, well done. Yes, Dr Ampica is a rare find. Years ago, shortly after I first met her she was treating me for higher than normal blood sugar. I'd made the connection between my condition and something known as metabolic syndrome which turned out to be correct. Empowered by the fact she had agreed with me, I went on to make a connection between metabolic syndrome and B12 deficiency and drew a diagram to explain it!!! She very graciously tolerated my ramblings which were completely wrong and she said something like, well we'll see later if you need a B12 shot or not, smiled and moved on. We became good friends immediately after but she does occasionally prod me about needing a B12 shot, in a good natured way, bless her.

Well, TSH was way DOWN from what it had been on my last three tests...down from almost 4 to 1.5 or something. Wacky. And she said no way Type 2 diabetes based on my FBS test. So....fit as a fiddle. I feel...disappointed. Maybe my sensations are all from my stress, ultimately. She did not suggest any other avenues to pursue. Oh well.