Tulsi joins the party of Common Sense

[In the jungle]

I am seeking a recommendation for a hospital in Bangkok or the greater Bangkok area that has a good reputation for the diagnosis and treatment of neurological conditions.

Since January of this year I have been suffering from a condition that affects my right leg.  I believe this condition to be neurological in nature.

In January I was in rude health.  I could walk long distances and I swam typically three kilometres a week.  Since then I have developed a condition that affects control and power of the muscles in my upper right leg.  I walk with a walking stick and walking much beyond 50 metres is a challenge.  I cannot drive as I cannot control the accelerator and brake with precision.  I cannot ride a motorcycle as my right leg lacks the strength to keep the bike upright.  I have had a number of falls with one resulting in two broken bones in my right foot.  I have constant pain which radiates down the inside of my right leg.  The pain seems to be worst at night and it is rare that I sleep more than two hours at a time.

I sought diagnosis and treatment from a local private hospital here in the south of Thailand but, despite considerable expense and the use of just about every diagnostic tool they have including MRI, I have not had a clear diagnosis.  At best I have had opinions from the four doctors I saw.  At times these opinions were contradictory and in one case the passage of time proved the opinion wrong.   I think I have reached the limit of their knowledge and experience.

I am therefore seeking a recommendation for a hospital in Bangkok or the greater Bangkok area that has a good reputation for the diagnosis and treatment of neurological conditions.  I will be staying in the Rangsit area.  Any assistance you can give will be appreciated.

[Sheryl]

Before seeing a neurologist you should get an MRI of the lumbar spine and consultant an orthopedic spinal specialist as this sounds much more like a spinal issue to me than neurological. (There is a neurological aspect in the spinal problem can cause nerve compression and nerve damage, but source is spinal).

 

I also sounds rather urgent since there is already loss of motor function.

 

You can get MRI at much loss cost than hospital here   https://mrithailand.com/en/contact-us-2/

You need lumbar spine, without contrast. No doctor order required and be sure they give you the scan on DVD.

 

Then I recommend you consult  https://www.bnhhospital.com/search-doctor/entry/4093/

Who is the best spinal specialist in the country

[herfiehandbag]

8 minutes ago, Sheryl said:

Before seeing a neurologist you should get an MRI of the lumbar spine and consultant an orthopedic spinal specialist as this sounds much more like a spinal issue to me than neurological. (There is a neurological aspect in the spinal problem can cause nerve compression and nerve damage, but source is spinal).

 

I also sounds rather urgent since there is already loss of motor function.

 

You can get MRI at much loss cost than hospital here   https://mrithailand.com/en/contact-us-2/

You need lumbar spine, without contrast. No doctor order required and be sure they give you the scan on DVD.

 

Then I recommend you consult  https://www.bnhhospital.com/search-doctor/entry/4093/

Who is the best spinal specialist in the country

You always offer sound advice. I copy many of your posts and keep them in a file in "notes". They have, from time to time, been helpful.

[In the jungle]

7 minutes ago, Sheryl said:

Before seeing a neurologist you should get an MRI of the lumbar spine and consultant an orthopedic spinal specialist as this sounds much more like a spinal issue to me than neurological. (There is a neurological aspect in the spinal problem can cause nerve compression and nerve damage, but source is spinal).

 

I also sounds rather urgent since there is already loss of motor function.

 

You can get MRI at much loss cost than hospital here   https://mrithailand.com/en/contact-us-2/

You need lumbar spine, without contrast. No doctor order required and be sure they give you the scan on DVD.

 

Then I recommend you consult  https://www.bnhhospital.com/search-doctor/entry/4093/

Who is the best spinal specialist in the country

 

The hospital in the south did an MRI specifically of the lumbar sacral region of my back and both hip joints.  The radiologist who assessed the MRI noted no abnormalities.  I have the MRI scan on DVD.

 

I should perhaps have mentioned in my original post I am 64 years old and male.

[Sheryl]

1 hour ago, In the jungle said:

 

The hospital in the south did an MRI specifically of the lumbar sacral region of my back and both hip joints.  The radiologist who assessed the MRI noted no abnormalities.  I have the MRI scan on DVD.

 

I should perhaps have mentioned in my original post I am 64 years old and male.

In Thailand radiologist reports of MRIs (especially of the spine) are not very reliable. The scan should still be read by a spinal specialist (who will also likely want an Xray as these can actually be better for spotting some things). So still suggest you see Prof. Wicharn.

 

If he also says origin of the problem is not spinal then indeed next stop should be a neuroligist in which case I suggest

 

https://www.bangkokinternationalhospital.com/doctors/dr-apichart-pisarnpong

 

 

[In the jungle]

1 minute ago, Sheryl said:

In Thailand radiologist reports of MRIs (especially of the spine) are not very reliable. The scan should still be read by a spinal specialist (who will also likely want an Xray as these can actually be better for spotting some things). So still suggest you see Prof. Wicharn.

 

If he also says origin of the problem is not spinal then indeed next stop should be a neuroligist in which case I suggest

 

https://www.bangkokinternationalhospital.com/doctors/dr-apichart-pisarnpong

 

 

 

Thank you.

 

I will follow your advice.

[thaisabai]

hello Sheryl

always very helpful information from you. much appreciated

 

question re Neurologist or an MRI specifically of the lumbar sacral region of my back 

 

any recommendation for Pattaya?

 

thanks and regards

 

thaisabai

[Sheryl]

8 hours ago, thaisabai said:

hello Sheryl

always very helpful information from you. much appreciated

 

question re Neurologist or an MRI specifically of the lumbar sacral region of my back 

 

any recommendation for Pattaya?

 

thanks and regards

 

thaisabai

For  problem in your lumbar spine you should see an ortho specializing in spine, not a neuro, and should come to Bangkok for that.

 

You can get MRI at several locations in Bangkok including Bang Na which is convenient if coming from Pattaya  https://mrithailand.com/en/contact-us-2/

 

However unless you are experiencing pain radiating to at lewast the thigh, or weakness in leg on that side, you might wait to see if doctor recommends MRI as might not be necessry.

[donmuang37]

On 3/21/2024 at 5:01 PM, Sheryl said:

Before seeing a neurologist you should get an MRI of the lumbar spine and consultant an orthopedic spinal specialist as this sounds much more like a spinal issue to me than neurological. (There is a neurological aspect in the spinal problem can cause nerve compression and nerve damage, but source is spinal).

 

I also sounds rather urgent since there is already loss of motor function.

 

You can get MRI at much loss cost than hospital here   https://mrithailand.com/en/contact-us-2/

You need lumbar spine, without contrast. No doctor order required and be sure they give you the scan on DVD.

 

Then I recommend you consult  https://www.bnhhospital.com/search-doctor/entry/4093/

Who is the best spinal specialist in the country

Agree that Sheryl is a real gem here.  Many thanks, Sheryl.

I would like to add that Thammasat University Hospital in Rangsit would be convenient for the OP.

I have been treated for many things there and am pleased with them.  I use Premium Care and am currently seeing a spine specialist due to age deterioration which is causing my spine to press on nerves which is weakening my legs.  Happy with the care I am receiving. .

Best of luck!! 

[In the jungle]

4 hours ago, donmuang37 said:

Agree that Sheryl is a real gem here.  Many thanks, Sheryl.

I would like to add that Thammasat University Hospital in Rangsit would be convenient for the OP.

I have been treated for many things there and am pleased with them.  I use Premium Care and am currently seeing a spine specialist due to age deterioration which is causing my spine to press on nerves which is weakening my legs.  Happy with the care I am receiving. .

Best of luck!! 

 

Thank you for mentioning that.  I will look into TU Hospital as it would certainly be convenient.

[thaisabai]

to Sheryl

hi Sheryl. I wonder if you have a recommendation of a doctor (preferably Pattaya, but BKK is also ok) for;

 

PAD

 

I can only walk 50-100 meters, then need to rest. (I am sitting most of the day, working on computer)

in addition, my toes are getting numb, mainly at night.

I am specifically interested to learn, at what stage amputation of a leg might be needed.

 

appreciate any comment, thanks

 

thaisabai

[Sheryl]

17 hours ago, thaisabai said:

to Sheryl

hi Sheryl. I wonder if you have a recommendation of a doctor (preferably Pattaya, but BKK is also ok) for;

 

PAD

 

I can only walk 50-100 meters, then need to rest. (I am sitting most of the day, working on computer)

in addition, my toes are getting numb, mainly at night.

I am specifically interested to learn, at what stage amputation of a leg might be needed.

 

appreciate any comment, thanks

 

thaisabai

Ling before amputation is considered other treatments are tried.  These can include medications and either angoplasty/stent or bypass surgery.

 

Exactly what symptoms do you have, and has a doctor diagnosed PAD? (There are other possible causes of trouble walking and  toe numbness).

 

Do you smoke?

 

Are you diabetic?

 

Are your lipids elevated (LDL cholesterol, triglycerides)?

 

Is the problem equally in both legs? 

[thaisabai]

thanks Sheryl

 

not diagnosed yet by doctor, planning to do so soon.

yes I smoke (1 pack/day)

not diabetic

Cholesterol/triglycerides normal (1 year ago)

Problem equally in both legs

Age: 78

often cramps in both lower legs in the morning.

 

regards

Thaisabai

 

[PPMMUU]

Your problem could be neurological, orthopedic, vascular, or something else. Perhaps what you need is a good diagnostician.

[Sheryl]

5 hours ago, thaisabai said:

thanks Sheryl

 

not diagnosed yet by doctor, planning to do so soon.

yes I smoke (1 pack/day)

not diabetic

Cholesterol/triglycerides normal (1 year ago)

Problem equally in both legs

Age: 78

often cramps in both lower legs in the morning.

 

regards

Thaisabai

 

With PAD it us absolutely essential to stop smoking.

 

Smoking constricts your blood vessels, and also contributes yo plaque deposits in the arteries. 

 

To rule out or cinfirm PAD, call BPH and see if you can get an appointment with Prof. Kittiasak Hongdu. He is a vascular surgeon based at Siriraj Hospital in Bkk but listed in the BPH website although no hours listed. 

 

https://bangkokpattayahospital.com/services/appointments-form/?fullname=Kiattisak Hongku, M.D.&center=Surgery Center

 

If PAD ruled out, lumbar spine would be important to check. You previously  asked about places for MRI, did you ever get one?  

 

 

[thaisabai]

hello Sheryl, it's me again with one more request for your valued advice (Pref BKK hospital Pattaya)

 

Myasthenia gravis

What are the signs of CVI?
Some common signs of CVI are:
Achy, heavy, or crampy legs
Pain that gets worse when you stand or better when your feet are raised
Itching and tingling in the legs
Swelling of the legs
Irritated, cracked, flaky, or thickened skin
Varicose veins
Wounds that are slow to heal

 

any doctor you can recommend?

 

as always appreciate your advice very much

 

thaisabai

[Sheryl]

8 hours ago, thaisabai said:

hello Sheryl, it's me again with one more request for your valued advice (Pref BKK hospital Pattaya)

 

Myasthenia gravis

What are the signs of CVI?
Some common signs of CVI are:
Achy, heavy, or crampy legs
Pain that gets worse when you stand or better when your feet are raised
Itching and tingling in the legs
Swelling of the legs
Irritated, cracked, flaky, or thickened skin
Varicose veins
Wounds that are slow to heal

 

any doctor you can recommend?

 

as always appreciate your advice very much

 

thaisabai

Sorry, I do not understand.

 

Have you been diagnosed with myasthenia gravis? By whom/where?

 

And all the other things listed are just other problems that you have?

 

Did you see vascular specialist Prof. Kittiasak Hongdu as previously advised?

[thaisabai]

thanks Sheryl

yes, these are the problems I am experiencing:

Achy, heavy, or crampy legs
Pain that gets worse when you stand or better when your feet are raised
Itching and tingling in the legs
Swelling of the legs
Irritated, cracked, flaky, or thickened skin
Varicose veins
Wounds that are slow to heal

 

will take your advice and see Prof. Kittiasak Hongdu

 

thanks and regards

thaisabai