Diabetes..

[eek]

I have a friend in his 70's. He has been getting more an more immobile from a leg infection/swelling problem (he really cant walk very far at all..and when he does its very very slowly and with a walking aid). Basically everyday he spends a small fortune on Bactigrass, strong antibiotics, bandage squares, and then tightly wraps his leg up. It is constantly red and swollen and often gets sores which will pop and ooze. This has been going on since i first met him, well over 2 year ago.

Lately, for the past couple of months, he has been going to Sri Pat Hospital every week, where after a few weeks of non-response from some powerful anti-biotics, he is put on a new batch.

The docs advice is also to watch his diet and raise up his leg as much as possible as long as possible, however, he is a bit stubborn about this (and at 70 odd years old, i can hardly blame him. One of his pleasures is food, and although he is trying to be healthier, he says he is just too old to not be enjoying his food. Valid point really!)

Well..what I would like to know, is some advice on what may be a better option and make his life more comfortable? He is a very proud man, and its hard for him to take advice, but if i have some solid advice for him, maybe he will take heed.

I know he has some saving set aside, as he mentioned he is considering going to Singapore or Bangkok's Bumrungrad for hopefully better advice. However, he is not a rich man by any means, so i think he is being very cautious about it and wary about spending so much to basically just end up being given the same advice.

Has anyone had any experience similar to this? Or have any advice? Surely such long term use of antibiotics (which are having little effect) are terrible for his health?! Im also seriously worried one day he will be told he needs the leg amputated!

If more info is needed or even photographs, I will talk to him.

Thank you kindly all!

[redhat99]

Your friend is in serious trouble. He better face the facts and face them soon. His leg could lead to an amputation. I do not know Sri Phet hospital or where it is. I have diabetes and receive treatment in the Samitivej Hospital soi 49 Sukhumvhit where I have been a patient for 20+ years. I see a Dr. who is a specialist in diabetes. She is a Thai but educated in Canada. She is very young and very good. She charges next to nothing. Unless you see her I would say correct treatment for diabetes is impossible in Thailand ANYWHERE especially in the rural areas. I live in Issan and have to go there for treatment. It is worth it as the treatment in all local hospitals is 5 years at least behind the rest of the world. I tried the local hospitals too including a military hospital in Sakhon Nakon. Just take the pills they say. Well she is far more advanced and aims, in my case, for me not to take the pills. I was found originally with a blood sugar level of 556(!!!) and riglycerides of 880(!!!) this is life threatening. Now 6 months later I have a normal reading constantly. I HAD TO CHANGE MY diet. I cannot tell you how important this is enough. It makes all the difference. I now am on a minimal dose of glucophage 500mg 2 time a day that's all I was previously on other meds as well. The complications of diabetes are many. The amputation is just the beginning for your friend if he wants to help himself he better change his diet, get a blood tester ( I have a mini ultr life) and check his blood daily. I did this at first 6 times a day minimum and now hardly ever at all as I can now understand what foods I can eat. I am 58 years old and if it was not for that hospital I might not even be alive. I had a lot of tests including an ultrasound of my arteries. This is imperative for diabetics who are at risk from stroke, heart diseas and death, etc. It is up to your friend. I cannot recommend any other hospital in Thailand whatsoever fr the standard of service Dr.s etc. Their prices are reasonable. Try Bumrungrad and see how much they rip you off and don't care. It is a factory for movie stars,arabs and tourists. My wife's father had a stroke went there and was told that's all she worte you are dead in the next 24 hours. We checked him out and went to Samitivej (my wife and I were out of the country her family took him there). He lived 5 more years onthe Samtivej treatment. Bumrungrad has all the Dr.s fired or resigned from Samitivej and other hospitals. Wake up your friend he could get old or not he could die tomorrow. I accepted it. The dr. is now considering to take me off all medicine and for me to control this with diet. A lot cheaper than medicine. Only one way to go...sorry.

[eek]

Thank you so very very much for your frank and honest reply. Its what is needed. I forgot to mention where Sri Pat Hospital is, sorry. Its in Chiang Mai, where my friend (and myself) are based. I will print out this page for him and we will talk it over. Very grateful.

[eek]

Grateful for redhats reply,but still would be helpful to read others experiences/opinions. Would be good to know others experiences of hospitals and treatments here. Thank you.

[lopburi3]

The idea that one doctor in one hospital is the answer to all problems is ridiculous to the extreme. There are many good doctors available at both public and private hospitals in Thailand. The mentioned hospital is not cheap by any means - but is a part of the Bangkok Hospital group and as such will have some of the best doctors/facilities available. But to even suggest the only proper treatment will be provided by that one doctor/hospital is well over the top.

Doctors need to know your ability to pay for tests - especially in the cheaper hospitals - or they will not schedule them. As a foreigner not using a high cost facility the assumption will be you must cut corners so more expensive options will often not be talked about (getting Thai doctors to even talk is often a difficult mission.

I know Chula government hospital here in Bangkok has some excellent doctors who offer private appointment consultations at very reasonable price if costs are a major factor. But even at top hospital a visit should not cost more than about 500 baht plus tests/medications.

But being in Chiang Mai and this being a long term problem expect he should be looking closer to home. I don't have any knowledge of the doctors up there but would suggest he see others, but be sure to tell them what has been done already.

[eek]

But being in Chiang Mai and this being a long term problem expect he should be looking closer to home. I don't have any knowledge of the doctors up there but would suggest he see others, but be sure to tell them what has been done already.

I agree, but so far, he has had little results from different Hospitals and Doctors here. So, he was thinking, if he could find one very good Doctor, just for an initial diagnosis / course of treatment, it may set him on track, then he can get follow up care in Chiang Mai, returning to the other Doctor/Hospital every few months or when necessary.

For myself, a few year ago, after getting nowhere in Chiang Mai with my own health problem (Hashimoto's Thyroiditis), I went to Bumrungrad to get a better diagnosis. After they got me on a track (a few visits to them), I now just visit sri pat for regular thryoid testing.

So, was thinking, if we can find a good Doc/Hospital for him, maybe they can give him more accurate advice.... ? Two years of bandage compression and antibiotics and still with an ongoing problem is far too long!

[redhat99]

The doctor's name was Dr. Kansuda Thongthai. I saw no less than 11 Thai doctors before seeing her including one at Samitivej that was very young and nowhere near as good as her. Expensive? No I paid for a carteroid artery ultra sound (a test hardly ever done here but very important), heart ecg, several blood tests, chest xray and nearly one hour physical and discussion with the Dr. Her charges were I believe 1100 baht for the appontment and about 5000 for all the tests.

I went to several hospitals in Bangkok and Issan forst. NO ONE I met knew what they were doing like her and gave pretty much the same pills. She even changed the pills explained to me why and her method worked for me.

(Poster has) been in Thailand more than 25 years. I believe I may have some experience here too especially for medical things as I have had several surgeries here.Sure go line up at Chulalongkorn I am sure they have some good doctors there. In the end you may even save 1000 baht or so. I found out myself that some of the Dr.s who work at Samitivej are proffessors there by the way. They won't overcharge you at Samitivej. If you have to stay for an operation it is more costly than other places. I know of very few hospitals here that do not try to get you to spend everything you have on further treatment there. Having been going to Samitivej for many years I have never found this to be the case there. In fact once they overcharged me accidently and called me back the next day to get a refund. For any extra you will pay it is better there by far than any Thai hospital anywhere as they have the most recently trained Dr.s. Dr. Kansuda is a perfect example. Fresh back from years in Canada she knows the latest methods.

That's it and my last post on the subject.

[ktamp]

Before moving here I was nurse and diabetes educator back in the states. Your friend is in trouble and mr redhat has given some great advice. Quite frankly, your friend's chances of saving that leg greatly depend on his willingness to be compliant with the prescribed treatment, including his diet. He must ask himself what he enjoys more....the food or the leg. I would advise seeing the doctor redhat has recommended since he has personal experience and your friend is willing to travel. The problem is too far gone for antibiotics and compresses at this point. The circulation in that leg is likely shot all to hel_l. I would also advise a full cardiac workup in case congestive heart failure is present and compounding the problem.

[eek]

Thank you ktamp (and again to all)

[Sheryl]

It is unclear whether this man's diabetes is properly controlled. As ktamp indicated, it is critical his blood sugar be under good control. If it is not, the question is why? If it is due to lack of compliance on hios part with diet and emds/insulin, BS monitoring etc well then he either needs to change or accept that he is going to lose that leg and suffer other complications as well.

If he is truly doing his best and his blood sugar is still not well controlled then he should see a another specialist in diabetes and it would be worth travelling for that to get the very best. However, if the problem is one of compliance on hios part then frankly even the best doctor in the world is not going to make a difference. So need to get clear on that point before spending a lot of money.

Regarding his leg, it may be worth having a vascular surgeon evaluate it. I can't really tell from your post wehther or not he has an infection currently (I know he is on antibiotics, but in Thaialnd that doesn't mean much). If there is an infection and it has not cleared up on oral antibitoics a course of IV antibiotics in-hospitl and possibly surgical debriedement may be in order. However such efforts, again, will not make much difference in the long run if his blood sugar is not well controlled.

[Jing Joe]

Hi I know a few people who say they have avoided amputation from the complications of their Diabetes circulation problems.

This is not a theraputic claim, it is just what they believe helped them.

Please reply if you want more details.

They have taken this product;-

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Precautions:

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[eek]

Once again, thank you all.

Sheryl, it would seem his blood sugar is on the high side. I passed on your information about proper dietary compliance, but although he does try to stick with a healthier diet, he isnt following the strict rules. I also spoke to him about the other things you and others have mentioned, for now he is thinking the different things said over.

Another friend of ours is wanting him to take a trip to Singapore, as he has more faith in the Singaporean hospitals, than the ones here. Has anyone had experiences with hospitals in Singapore?

I realise that he needs to follow the basic things Sheryl mentioned. But, at the same time myself and a mutual friend were thinking, if he got to see an excellent doctor, where he was given a diagnosis and plan to follow, he is likely to have more faith in the advice and follow it.

Appreciate any further thoughts/info, particularly advice about the idea of hospitals in Singapore..are they possibly better than Bangkok?

[Sheryl]

I don't think you will get anything in Singapore you cannot get in Bkk.

Theere should be some really good diabetes specialists and vascular surgeons at CM University Hospital and for sure there are in Bkk, let me see what recommendations I can come up with and will get back to you.

Meanwhile would help to know where you has been getting care so far. Has he already tries CM University Hospital? Specifically, Sriphat special medical clinic located on the Maharaj (Suan Doc) hospital grounds. Which by all accounts is where ythe best specialists in CM are to be found.

[eek]

Sheryl, as always, wonderful advice.

Well..actually, he has been going to Suan Doc/Sri pat recently. Please take a deep breath here.. .Well..at first i recommended him my Doctor, Dr Ampica (Endocrinologist), who i personally think is a wonderful doctor. He said he didnt like that she started ticking off a long list of tests without even discussing anything with him. So, he decided not to go back to her. He then started seeing another Doctor there, who he says he likes and has been seeing for a couple of months, but he isnt getting very far other than being given different antibiotics and told keep his leg clean and wrapped up. I asked him if she was an Endrocrinologist, and he said he wasnt sure, and that she is based in the General Medicine Department. So, at this point, im not sure what her experience with Diabetes's is.

But, i would be very grateful for any information on Doctors you may know of to go to at Sri Pat, because hopefully he will accept one of the Doctors ways of doing things. Or, at least, go on someone elses recommended advice (rather than mine!). I wasnt sure what other Doctors to go to at Sri Pat, and had not thought or heard of a vascular surgeon until you mentioned it.

One of the things is that he said wants to see if people here have conflicting advice, or start saying the same things.

My concern now, is that his other leg seems to be developing a problem too. If that happens, he will no longer be able to walk.

I realise that in the end it is his choice about what he will do regarding this. But, I feel that the least i can do is gather some information for him, through research and through others, and then offer to go with him. After that, i leave the options with him to think over. Ultimately it is his choice.

Thank you kindly Sheryl.

[fullwhenempty]

Good for you for caring.

One of the reasons he may lack motivation, besides his age, is that he may not believe anything can actually be done. There is an excellent movie called 'Simply Raw' about curing Diabetes within 30 days. You can track it down online or contact me by pm. I like it because it shows the struggle of the participants and their joy at the results they achieved. I found it inspiring and transformational! Perhaps he will too.

There are other simple inexpensive home cures which I won't post, since those unfamiliar with authentic natural methods, can't resist displaying their prejudice. pm me if you wish to know more.

[eek]

Update at this time is he is being checked into the local hospital here tomorrow for a min of 5 days for intravenous antibiotic treatments and under the care of a Vascular Surgeon.

Keeping my fingers crossed about this being a step in the right direction.

Thank you all again for your help.