Help

[dmcrory]

Everyone,

I came to Bangkok for the Medical Resources. I have gone to a local Clinic and the Doctor has brushed me off because she doesn't know and it isn't a quick fix procedure at least that's how I feel.

I have been sick for over a year I need help in finding a Doctor that can diagnose what is wrong and stay with my case until it is resolved. Run tests to eliminate things. A Doctor that I can meet with for 30min Consultation and it won't be interrupted every 3 min's someone that will gather the facts and then through a process of elimination tests and find the answer or at least eliminated it down to a short list of things.

Is there any Doctor capable of this in Bangkok?

Am I asking to much maybe I am dreaming.

I am not from here so I don't know where to begin. I don't want to go to a brand name big hospital and have then start emptying my wallet. I want a Doctor that can problem solve when someone is sick and eliminate it down. You know good old problem solving.

Any recommendations or suggestions. I just want to be healthy tired of being sick.

Thanks

D

[meatboy]

you can try a doctor who has a private clinic,sheryl should be able to recomend one,but if you have been ill for over a yr.its hospital you should go.

if you are worried about the cost before your health,you had better GO HOME.THAILAND IS NOT THE PLACE TO BE ILL WITH NO INSURANCE.

[Sheryl]

You need to tell me something about the nature of the problem, in order for me to know what type of doctor you need. Medical care in Thailand is highly specialized.

You also need to indicate where in Thailand you are. Bangkok? Other?

In most parts of Thailand, and especially in Bangkok, most doctors use the outpatient facilities of a hospital to see patients and very few have their own private clinic. It's a bit different in Chiang Mai, but by and large to see a doctor on an outpatient basis you do need to go to a large hospital. Not as an inpatient, of course, but for the outpatient consultation and whatever tests may be needed. Small clinics, especially in Bangkok, are usually best avoided. Seeing a doctor in a hospital outpatient department will not necessarily cost a lot more than seeing one in a small clinic, but will allow for much more by way of lab facilities etc and also often allow for access to better /more skilled doctors. So I suggest you not stick to this idea of avoiding large hospitals.

[dmcrory]

Everyone,

Thanks for the information Sheryl.

I am in Bangkok.

Today, the worst I have been for a long time ringing ears and nausea

Symptoms are Random have lasted for at least 7 months

Ringing in the ears at times, had today

Nausea (feel terrible) at times, had today

Disequilibrium when walking (unsteady walk, like I am going to fall down at times, walking on uneven surfaces like I am going to fall) had today

Stiffness, Burning, numbness (use to be tingling) in the legs and feet had today

RT Mid- Lower Abdominal Pain Sometimes with Nausea - After Levoflxacin gone so far

Consistent dry lower cough - Start Prevaid 2 days ago little better but still there.

Went to local clinic referred to Rheumatologist Bumrungrad,(why I not sure)

Levoflxacin 500mg finish 2 days ago. Stomach pain gone so far

Enlarge prostate done in Feb 2016 Ultra sound

Blood test ESR 62 June 2016

WBC 13.24 June 2016

ANA Titer Positive 1:320 June 2016

Anti CCP Negative June 2016

H. Pylori Positive blood test last Feb 2016 Cambodia

H. Pylori Negative stool test June 2016 (Did not take the Triple Therapy) June 2016

I don't understand what ANA Titer is Lupus or Anti CCP.

I think I have a blood circulation problem but I don't know.

Blood pressure

07/06/2016 150/96

09/06/2016 139/90

Doc I went to thinks autoimmune whatever that is.

How much to see a Rheumatologist at Bumrungrad. I think I should be in the ear and balance clinic.

Freaked out and panic

I have lived in Asia for 10 years mainly Cambodia only been back home for 3 months in the 10 years. I don't mine spending money if someone takes the time and actually problems solves and isolates. I don't know anyone here. I stopped drinking and coffee so hard to met people.

Went to a doc here at a local clinic doc to busy for my case I feel. They didn't know and to busy. Probably wrong place to be. I don't think a easy answer.

Broken toe that sticks out and swollen from walking I it was definitely inflamed at the time of the blood test. Will that cause a elevated ESR.

Tried

Ativan

Draminene

Merison

B-12 supplement seem to help before Apr with the tingling and numbness in the legs. Was walking 4km each day before June 01, 2016 and coming here. Some bad days but over all ok. More stomach pain. Had gf hold my hand for balance back in Cambodia. Was good here for 5 days now the worst it's ever been.

It's like I would walk and all of sudden the rug is pulled out from under my feet.

Walking across a slope such as a driveway through my balance off.

I don't know and I am extremely worried. I can't function to well because I can't walk so well at times. Help!

[mike13]

Seems a problem concerning your inner ear (internal ear, auris interna).

[Sheryl]

What you list is suggestive of more than one problem.

Prostate enlargement is certainly unrelated to the other symptoms mentioned. Borderline hypertension, also likely unrelated to any of the other things.The abdominal pain might or might not have any relationship to the other problems mentioned; could just be the untreated h. pylori.

You were referred to a rheumatologist because you have a very high ANA titer along with elevated ESR. An elevated ESR indicates inflammation; an elevated ANA titer (yours is very elevated) indicated autoimmune disease. CCP is specific to rheumatoid arthritis and negative but that still leaves a number of autoimmune conditions possible. SLE (lupus) and Lyme Disease are two that can cause symptoms similiar to what you report. (Lyme is of course an infectious disease, but it can have autoimmune sequelae).

You should do as the clinic recommended, and consult a rheumatologist. Your situation is not one that a non-specialist can manage no matter how much time they have nor how willing. A consultation will run about 2,000 baht and then there may be a few thousand baht more of additional lab tests to help pinpoint the problem.

While inner ear disturbances (and some neurological conditions) can cause balance problems and ringing in the ear, that does not square with the elevated ANA and ESR. Start with a rheumatologist as the clinic doctor advised. I don't know if he referred you to a specific doctor, but I can recommend the following, both at Bumrungrad:

https://www.bumrungrad.com/doctors/Virat-Pinyopornpanit

https://www.bumrungrad.com/doctors/Virat-Pinyopornpanit

Both are US-trained and US board certified, and very good and very thorough.

Until a real diagnosis has been obtained I suggest you avoid self-treating with various drugs, they will only make it harder to figure out what is going on.

This is a complex, and potentially serious, problem and there is no way it can be handled by other than specialists at a large hospital. In fact the clinic you went to did better by you in telling you to see a rheumatologist than I would have expected. Don't waste any more time and money trying to get this dealt with on the cheap, it will cost you more -- in both money and possibly health - in the long run.

[dmcrory]

Sheryl,

Thanks for the information. I have an appointment tomorrow afternoon at Bumrungrad with the rheumatologist. I not worried about money just want to get a diagnoses and treatment plan.

My ringing in the ears is gobe and right now 9:00PM I feel better. It's random. Hopefully, it can be treated and I can get on with life.

Thanks for your help! I'll keep you advised.

[dr_lucas]

@Sheryl

You wrote the same doctor twice.

Who was the second doctor you wanted to suggest?

Any other recommended doctors in other private hospitals except for Bumrungrad?

[Sheryl]

https://www.bumrungrad.com/doctors/Hiroshi-Chantaphakul

 

Bumrungrad has a strong comparative advantage  when it comes to senior, western-trained  rheumatologists, for some reason.

 

This one at Samitivej looks promising based on credentials, I have no direct feedback on him  https://www.samitivejhospitals.com/en/doctors/yotsawee-sanguanjin/?initial=all&hospital=all&specialty=sspc_421&keyword=

He did a fellowship at the Univ of Virginia and is board certified in the US. Comparatively young.

 

Ditto this one at Bangkok Hospital

https://www.bangkokhospital.com/index.php/en/find-a-doctor/doctor-profile/?id=461&doctor=Dr._KANYAKORN_JAOVISIDHA

[Darkkakashi]

even if I am not involved in this topic, Thank you Sheryl for all your help, you are soooo helpful !

 

the world would be a better place with more people like you, helping others without being interest-oriented

Edited January 25, 2018 by Darkkakashi