Feeling Dizzy - which hostpital to visit in Pattaya?

[JarekN]

It has been 2nd week now that I've been feeling dizzy (no vertigo.) I saw a doctor last week in Hua Hin who proscribed something for middle ear (just a guess on her side) but till today my situation has not improved and if anything has just gotten worse.

I am thinking of going to one of the hospitals and doing a more detailed blood test with possible other tests. My insurance only covers emergencies and cases where I require hospitalization so looks like this one will be coming out of my pockets. Any suggestions as to which of the hospitals in Pattaya has reasonable fees for doctor and blood/etc tests?

I should mention I've been having some issues with my abdomen, which could be IBS but so far has not been confirmed... Not sure if the two are related as the dizziness is just recent.

Thanks!

Edited January 6, 2016 by JarekN

[JarekN]

After a bit more of research I think I've narrowed it down to Pattaya City Hospital or Pattaya Memorial Hospital, any thoughts?

[NickJ]

I have used Pattaya Memorial. I saw two Dr's there. Teewin Ngarmsrikam MD. He seemed to be a fairly bright guy. A bit young but he is friendly.

[Sheryl]

Just to confirm -- when you say dizziness but no vertigo, you mean you feel light headed but do not have any sensation of things spinning around, is that correct?

It is a very important distinction because if your problem is vertigo (which is what the previous doctor's treatment was for) then you need to see an ENT specializing in vertigo, which would require either Bangkok Pattaya Hospital (Dr.Apinan Na Nakorn)

or a trip to Bangkok.

Whereas if it is lightheadedness only, then it becomes a matter of excluding various causes such as anemia, abnormally high/low blood pressure and abnormalities of heart rhythm. etc for which an internist is appropriate. In which case Pattaya Memorial is fine. You'll need to use your own judgement as to whether or not the doctor is sufficiently thorough. If blood count, blood pressure and EKG are normal, and especially if the lightheadedness is only intermittent then a 24 hour heart rhythm monitoring may be advisable. Meanwhile you can help the investigation by checking your pulse while you are feeling lightheaded - especially noting whether or not the rhythm seems regular or if it feels like there are any skipped beats.

[NeverSure]

Always listen to Sheryl, not me, LOL.

If the things she recommended don't solve it, get an MRI and of course a reading by a radiologist. You could have something like a meningioma which is a non-malignant tumor which is usually fairly easy to remove. Usually. Just be sure to stay on it because something is definitely going on.

[JarekN]

Hi,

Correct, no sensation of things spinning, more like an off balance feeling/weakness which seems to come more often and last longer time, especially more visible in the evenings.

Just to confirm -- when you say dizziness but no vertigo, you mean you feel light headed but do not have any sensation of things spinning around, is that correct?

It is a very important distinction because if your problem is vertigo (which is what the previous doctor's treatment was for) then you need to see an ENT specializing in vertigo, which would require either Bangkok Pattaya Hospital (Dr.Apinan Na Nakorn)

or a trip to Bangkok.

Whereas if it is lightheadedness only, then it becomes a matter of excluding various causes such as anemia, abnormally high/low blood pressure and abnormalities of heart rhythm. etc for which an internist is appropriate. In which case Pattaya Memorial is fine. You'll need to use your own judgement as to whether or not the doctor is sufficiently thorough. If blood count, blood pressure and EKG are normal, and especially if the lightheadedness is only intermittent then a 24 hour heart rhythm monitoring may be advisable. Meanwhile you can help the investigation by checking your pulse while you are feeling lightheaded - especially noting whether or not the rhythm seems regular or if it feels like there are any skipped beats.

[Sheryl]

A meningioma would cause vertigo, not light-headness. Again, very important to be clear which is the problem. Vertigo feels like you are spinning around or on a very rocky boat. (Causes are usually not as serious as mengioma, though that is one possible cause - neuro exam wiould help determine if MRI is indicated.)

In light-headedness without vertigo, you do not feel like anything is moving per se, you just feel like you are about to faint.

[JarekN]

Thanks Sheryl,

The first time I felt it was while I was walking, I felt as if I was being pulled to one side. When I sit a bit forward, it feels like I might fall forward, but for sure nothing spinning - unless the spinning is very small and hard for me to notice.

A meningioma would cause vertigo, not light-headness. Again, very important to be clear which is the problem. Vertigo feels like you are spinning around or on a very rocky boat. (Causes are usually not as serious as mengioma, though that is one possible cause - neuro exam wiould help determine if MRI is indicated.)

In light-headedness without vertigo, you do not feel like anything is moving per se, you just feel like you are about to faint.

[NeverSure]

A meningioma would cause vertigo, not light-headness. Again, very important to be clear which is the problem. Vertigo feels like you are spinning around or on a very rocky boat. (Causes are usually not as serious as mengioma, though that is one possible cause - neuro exam wiould help determine if MRI is indicated.)

In light-headedness without vertigo, you do not feel like anything is moving per se, you just feel like you are about to faint.

I don't want to be argumentative Sheryl, but as you know, the brain is a complex thing with each part controlling different things. This meningioma caused fainting as it had completely grown around both carotid arteries (one circled in red). The main part was inner between lobes rather than outer as is usual and the treatment included needing artery bypasses done by a team of neurosurgeons and cardiac surgeons.

Agreed this one is very atypical.

I wouldn't rule out anything other than getting all indicated tests.

Cheers.

Edited January 6, 2016 by NeverSure

[BangkokKen]

Any short time memory loss?

Itchiness? Red unexplained patches on the skin?

Problems sleeping?

[jimmybkk]

Don't be shy about explaining to whichever doctor you see the situation regarding your insurance. In my experience they can be quite accommodating, and if an expensive procedure is required they may be quite happy to admit you rather than lose the business. I can't speak for Memorial or Pattaya Inter, but there are a lot worse places to spend a night or two than in a room at Bangkok Pattaya Hospital.

Also, if you are prescribed medication and will be paying for it from your own pocket there is nothing wrong with telling the doctor that you would like him/her to write down the name of the medicine he/she would prescribe as you intend to purchase it at a pharmacy outside the hospital.

[JarekN]

My memory sucks for a long time, but no patches on skin and I sleep like a baby

Any short time memory loss?

Itchiness? Red unexplained patches on the skin?

Problems sleeping?

[JarekN]

So I ended up visiting Pattaya City Hospital in Soi Bukhao, got there late and spent few min with doctor going over my condition, he does not think it's related to brain based on the symptoms I described and the physical evaluation he performed. Requested that we do few blood tests and stool test (which I asked for due to my abdominal issue) and asked that I have the blood work done first thing in the morning. I told him that I didn't eat anything since last night but he still said that it is best to do the test in the morning so we'll see how that goes tomorrow. I must say I was fairly impressed with the place, doctor and nurses I was interacting with spoke decent English and were very helpful.

[JarekN]

Blood results were fine, one thing they did not test and the doctor today suggested it could be is vitamin b12 deficiency... She didn't ask me to do another test, just prescribed B1+B6+B12 to take 3 times a day for 7 days and told me that if this doesn't work that I should see neurologist... Now after doing some bit more of reading, the symptoms I have do fit with it, just not sure if 7 days will be sufficient... Another thing I've read is that blood test could be performed to see if that is the case, so I think that if things are not improved after this I'll just try to get blood test done to see if it is B12 or not... Cause if it is, then I think that the B injections would work quicker. And if the test does not show deficiency then I'll be left with neurologist and MRI by which time I think I'll be back in VN where the test is much much cheaper...