Chiangmai Ram, What Would Your Reaction Be?

[doppa]

i'll keep it as short as possible.

for over a year iv'e had this awful dizziness, to the point of it driving me nuts now.

numerous visits to ram to identify the problem, ear, nose, throat, blood, heart, carotid arteries, and the worst fear, an mri brain scan, and this is where it get's interesting.

the mri scan was june last year, after being given the results in paper form by the nurse, the doctors meeting went well, 'nothing to concern you he said', however take these' baby asprin', it will thin your blood, sending it quicker to the brain, and hopefully cure the dizziness, i wish.

march of this year i made an appointment to see a neurologist,it was he who suggested i did all of the above tests [except the mri scan] and during one consultation he brought up on his computer the mri brain scan, and to my absolute astonishment he told me i had suffered a very minor stroke!

as you can imagine i was in total shock, there was no obvious facial signs that i'd had one [some may beg to differ] but it was the thought that the original doc who suggested the mri didn't inform me of my results,

now from where i come from , that's just bad practice, and probably more, it's just not on, why bother going to a hospital if they don't reveal whats wrong, what's the point, if this doc wasn't qualified to 'read' a brain scan,he should have referred it to a neurologist

this may be a one off, i don't know, it's now in the hands of the ram ceo, oh, and the doctor concerned has now left the hospital.

nb. i still have the dizziness, and no one seems to any nearer solving this mystery.

[elektrified]

Get to another hospital for a 2nd opinion ASAP. Sripat at CMU would be an excellent choice. Not as fancy as RAM but there are many good docs there. Ask/demand to see a senior Professor of Neurology for a 2nd opinion.

Best of luck.

[hellodolly]

I had a physical there once including a x ray of my foot and shoulder. The shoulder showed nothing. It turned out to be a by product of Lipatar.

The foot x ray showed a broken Tibia bone with a screw holding it together.

The doctor told me I should have it fused right away. The doctor who had done the operation in Canada had told me as long as I could handle the pain do not fuse it. When he was on vacation his replacement told me the same thing. He said 15% of the time it does not work. You are left with the pain and a foot that has no mobility.

Four years after the Ram x ray I went to another specialist here in Chiang Mai he is semi retired and works mainly in his clinic. He has a x ray machine and looked at the x ray, He told me if I could walk 100 meters not to have the operation or if I could sleep with pain meditation not to have the operation. He went on to explain why. He said in his 40 years of practice he had only seen this operation done once. As mine would be very complicated.

So needless to say I am leery of the Ram that doctor there did not even give it a moment of thought. As for suggesting aspirin it is a common practice to take a baby aspirin to help prevent strokes. There is a more powerful medicine out that doctors will prescribe it is called Wharfin. (not sure of the spelling) . But it has side effects such as slow blood clotting and easy bruising. Also you need to have your blood checked every month. There is a clinic tn the Sripat Swan Dok area that does it for 90 baht.

[koosdeboer]

Three years ago I went to chiang mai ram because of pain in my rib. They did an X-ray, it showed a tumor. Doctor said non malignant, no problem. Didn't trust him and wen to Sriphat. Cancer, multiple myeloma. Ajaan Lalita saved my life. Sriphat is the best.

[eyecatcher]

I just wonder about the competence of medical proffessionals here and their sweeping diagnoses.

Mrs E took her clever neice (9yrsold) to see a doctor for some advice , because after coming from an Isaan school; she was now having trouble concentrating for any length of time.

The diagnosis, without tests ; "she's got downs syndrone"

What a shock and an insult for any parent to hear that.....my response cannot be published here.

Agree with the above, second and third opinions are vital, even try a private hospital like the McCormack, hopefully they dont employ numptys

[Lifer]

Get to another hospital for a 2nd opinion ASAP. Sripat at CMU would be an excellent choice. Not as fancy as RAM but there are many good docs there. Ask/demand to see a senior Professor of Neurology for a 2nd opinion.

Best of luck.

Sripat Hospital is not at CMU. It is down the street 1 to 1.5 block from Suan Dok Gate in front of the Government Hospital and Nursing College. Can't miss it. It is almost on the road and a number of stories high. It's a private hospital but shares specialists and some testing facilities with Suan Dok Hospital connect to it. Care is good and prices very reasonable compared to Ram.

[elektrified]

Get to another hospital for a 2nd opinion ASAP. Sripat at CMU would be an excellent choice. Not as fancy as RAM but there are many good docs there. Ask/demand to see a senior Professor of Neurology for a 2nd opinion.

Best of luck.

Sripat Hospital is not at CMU. It is down the street 1 to 1.5 block from Suan Dok Gate in front of the Government Hospital and Nursing College. Can't miss it. It is almost on the road and a number of stories high. It's a private hospital but shares specialists and some testing facilities with Suan Dok Hospital connect to it. Care is good and prices very reasonable compared to Ram.

O.K. let's not be overly pedantic. Sripat is associated with CMU. I have 2 doctors who have clinics there and they teach at CMU. Their business cards also have CMU logos on them. It is on the CMU campus. If I wanted to be pedantic, Sripat is a building; not a hospital and Suan Dok is not a government hospital it is a semi-government hospital.

[chiang mai]

Go see Dr Surat Tanprawate at Sriphat, he's an assistant professor of Neurology at CMU and he's excellent, 13th floor.

[Krupnik]

Interesting. I've had alot of dizziness recently which has progressed to being quite severe, I went to the doctor who told me it was low blood pressure and I didn't need to do anything, there was no cause. I've still got the dizziness, it's driving me crazy too, but I don't like to take medicine unless it's absolutely vital so I continue to live with it for the time being.

As for CM Ram, they were great when I had dental work done there, although expensive. Since my brother's experience recently there though my faith was lost.

Siripat were great when my friend had an accident and recently for serious stuff I've gone there and they have proved to be very good.

[ianf]

If I were you I would hotfoot it to Bangkok to the Bhumijad (spelling?) hospital near Sukhumvit. One regular poster on this board goes there often and swears by their treatment and professionalism. Send me PM if you need more details. And best of luck to you.

Incidentally, you can fully recover from small strokes. The common treatment is wayfarin (spelling?) which thins the blood, not baby aspirin! Strokes, for those that do not know, are caused by a burst blood vessel in the brain. Large bursts, thus flooding an area of the brain with blood, are dangerous and can cause dysfunctions such as word retrieval, memory loss and partial paralysis. Go easy and get some good advice, please.

[jackr]

Have had same for a year or so, starting right after the earthquake.

Op: take it you've looked into the obvious - dehydration, low sodium (salt)? It's quite hot here.

[moe666]

I stayed 10 days in Ram cannot complain about the service or the treatment. The Dr was actually a bit to conservative for my likeing. I donot trust Drs here are in the states. Typically if they cannot cut it out or give you a pill to cure it guess what it doesn't get cured.

To the OP my daughter surffers from dizzy spells as well she is in the process of haveing it checked out in the states but guess what in the states there throwing their hands up without much sucess in the treatment.

[eek]

Ram wrecked my thyroid. Its documented here in the forum. Months of messing me up (and large bills for the pleasure) led me to spend a small fortune flying for months to Bumrungrad in Bangkok. The doctor was shocked at my medical records. After my levels were regulated she recommended me a doctor in Sripat, who has been great.

I now need to take thyroid medicine daily for the rest of my life in order to keep my thyroid levels normal.

[doppa]

Have had same for a year or so, starting right after the earthquake.

Op: take it you've looked into the obvious - dehydration, low sodium (salt)? It's quite hot here.

that's exactly the same time my dizziness started the doc reckoned it was coincidence when i suggested the quake might have upset my body balance, i try and keep hydrated, might try the sodium though,

[Beetlejuice]

Get to another hospital for a 2nd opinion ASAP. Sripat at CMU would be an excellent choice. Not as fancy as RAM but there are many good docs there. Ask/demand to see a senior Professor of Neurology for a 2nd opinion.

Best of luck.

This is excellent, grade A advice.

Don`t waste any more time at the Ram, and obtain a proper diagnoses before the situation becomes any worse.

Edited May 9, 2012 by Beetlejuice

[mausbiber]

If you think you need a neurologist for your disease I would like to recommend Dr. Nantaporn Tiyapun.

She is a female lecturer at CMU and has a private clinic north of the moat in Chang Phueak.

Her English is pretty good

I had problems with my eyes, squinting for some months. A RAM neurologist give tablets to me - no success after 4 weeks.

Getting the medicine from Dr. Nantaporn the symptoms disappeared within 2 weeks.

I prefer to visit her clinic because I don't have the time to wait for hours in Suan Dok.

The address of the clinic: 193/1 ChangPhueak Rd, Chiang Mai 50300; Phone: 053 226920

In google-maps you can find the location of her clinic here:

http://maps.google.de/?ll=18.803979,98.985481&spn=0.001031,0.003449&t=m&z=18&layer=c&cbll=18.803977,98.985478&panoid=LqlzUqmLF40s6U7d3m8z6Q&cbp=11,283.22,,0,0

If you use a navi: the coordinates are 18,80435 N 98,98541E

Edit: wrong link

Edited May 9, 2012 by mausbiber

[chiang mai]

If I were you I would hotfoot it to Bangkok to the Bhumijad (spelling?) hospital near Sukhumvit. One regular poster on this board goes there often and swears by their treatment and professionalism. Send me PM if you need more details. And best of luck to you.

Incidentally, you can fully recover from small strokes. The common treatment is wayfarin (spelling?) which thins the blood, not baby aspirin! Strokes, for those that do not know, are caused by a burst blood vessel in the brain. Large bursts, thus flooding an area of the brain with blood, are dangerous and can cause dysfunctions such as word retrieval, memory loss and partial paralysis. Go easy and get some good advice, please.

And I would not, Bumrungrad is expensive, overated and there are far better doctors available in other hospitals at a fraction of the price - my personal view is that Bumrungrad is primarily a marketing machine.

Warafin (it's actually rat poison) is not intended for strokes and asprin is not a bad choice for a first line of defense, anticoagulants such as Plavix are probably more suitable. I agree about getting professional advice however which neither of our posts is.

[cloudhopper]

Strokes, for those that do not know, are caused by a burst blood vessel in the brain.

You can include yourself in that group. The stroke you are describing is less than 15% of all strokes, and Warfarin, aspirin and other meds that interfere with blood clotting mechanisms would worsen this type of stroke. The vast majority of strokes are caused by a clot which blocks the flow of blood, same as a heart attack.

[chiang mai]

A stroke or occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. ANTI coagulants are therefore very useful in this situation.

http://www.medicalnewstoday.com/articles/7624.php

[DavidOxon]

bursting vessel in the brain is an anurism...

[chiang mai]

bursting vessel in the brain is an anurism...

No, a bursting blood vessel in the brain is a hemorrhagic stroke, an aneurysm is merely the bulging of the wall of the blood vessel.

[uptheos]

bursting vessel in the brain is an anurism...

No, a bursting blood vessel in the brain is a hemorrhagic stroke, an aneurysm is merely the bulging of the wall of the blood vessel.

David could mean that it's bulging and could be on the point of bursting, as opposed to a blood vessel that has burst...I'm not sure. You are right and if it bursts it then becomes a cerebral haemorrhage.

[KhunVee]

You might suffered a light TIA (Transient Ischemic Attack) probably during your sleep as you don't remember the event but only suffer the aftermath symptoms.

A TIA is difficult to diagnose (even immediately after the event) does not always leave trace of evidence.

A TIA feels like a stroke (CVA = Cerebro Vasculair Accident) but is only a temporarily event, usually passes within 1-2 hours.

Mostly caused by a short lack of oxygen supply to your brain caused by a blood cloth, a very low red-cell blood count, low blood pressure,.... and so on.

A TIA is not to be ignored, even when all symptoms go away after a while.

Sometimes it's completely gone after a day already.

You need to see a Neurologist who will follow up as this could be followed by a CVA.

Many (no numbers sorry) patients who suffered a TIA will suffer a CVA within a year after without treatment or follow up.

The follow-up is mostly what your Neurologist did,.... blood thinners, control blood pressure and Cholesterol.

Also you should get an ECG ASAP (Electrocardiography) and check your heart for rhythm disorders.

I'm no surgeon or doctor, but an EMT and saw this happening many times over and these kind of events leads to TIA/CVA in 90% of the case.

This is my two cents.

[PhotoJohn]

I had a similar problem with dizziness for quite a long time. Sometimes worse than others.

It became an emergency after about eight days of not taking my regular low-dose aspirin. My dentist asked me to discontinue the aspirin prior to doing gum surgery.

Anyway, I became so dizzy, I thought I might pass out. I went to the emergency room at Sriphat. They didn't find anything wrong with me, but said that stopping my aspirin probably resulted in my symptoms being more severe.

The doctor recommended that I make an appointment for a CTA Scan. I consulted with my family doctor (Dr. Morgan) and she concurred. A few days later I had the scan which showed a Minimum Coronary Calcification (minor blockage).

Dr. Morgan put me on cholesterol lowering medication, recommended that I improve my diet and get more regular exercise.

It's been over a year and my dizziness has been cured.

[KhunVee]

bursting vessel in the brain is an anurism...

No, a bursting blood vessel in the brain is a hemorrhagic stroke, an aneurysm is merely the bulging of the wall of the blood vessel.

Exactly.

As soon as a Aneurysm bursts it becomes a Subarachnoidal Hemorrhage (maybe bad translation) or Meningeal Hemorrhage.

[eyecatcher]

There seems to be a lot of unqualified medical experts on here.(yes, myself also before anyone points out)

and not sure it helps the OP

[hellodolly]

I had a similar problem with dizziness for quite a long time. Sometimes worse than others.

It became an emergency after about eight days of not taking my regular low-dose aspirin. My dentist asked me to discontinue the aspirin prior to doing gum surgery.

Anyway, I became so dizzy, I thought I might pass out. I went to the emergency room at Sriphat. They didn't find anything wrong with me, but said that stopping my aspirin probably resulted in my symptoms being more severe.

The doctor recommended that I make an appointment for a CTA Scan. I consulted with my family doctor (Dr. Morgan) and she concurred. A few days later I had the scan which showed a Minimum Coronary Calcification (minor blockage).

Dr. Morgan put me on cholesterol lowering medication, recommended that I improve my diet and get more regular exercise.

It's been over a year and my dizziness has been cured.

I see Dr Morgan for all my ailments. She has sent me to see specialists and has all their reports in my file. She knows every thing I take . I hold nothing back.

Jumping from hospital to hospital and doctor to doctor leaves you open for bad advice such as one doctor telling you to take and Warfarin and another telling you to take Ibuprofen for some thing else. The two are a dangerous combination. Best to have a doctor who has knowledge of all your conditions and medications.

[Ulysses G.]

Jumping from hospital to hospital and doctor to doctor leaves you open for bad advice such as one doctor telling you to take and Warfarin and another telling you to take Ibuprofen for some thing else. The two are a dangerous combination. Best to have a doctor who has knowledge of all your conditions and medications.

This sounds like good advice to me.

[JoePai]

Jumping from hospital to hospital and doctor to doctor leaves you open for bad advice such as one doctor telling you to take and Warfarin and another telling you to take Ibuprofen for some thing else. The two are a dangerous combination. Best to have a doctor who has knowledge of all your conditions and medications.

This sounds like good advice to me.

Good advice is to always get a second opinion

[KhunVee]

Jumping from hospital to hospital and doctor to doctor leaves you open for bad advice such as one doctor telling you to take and Warfarin and another telling you to take Ibuprofen for some thing else. The two are a dangerous combination. Best to have a doctor who has knowledge of all your conditions and medications.

This sounds like good advice to me.

Good advice is to always get a second opinion

2nd Opinion: YES

2nd Treatment: NO