The aches weren't due to exercise - it was Typhoid fever!

[TallGuyJohninBKK]

Went by Mission Hospital in BKK yesterday for a general checkup with the American doctor there, Dr. Nick Walters. Was immediately reminded what a vastly better and more productive experience it is discussing medical issues/concerns with him vs. almost all of the Thai MDs I've encountered here, including those from some of BKK's best hospitals who have studied/trained in the west.

Took the opportunity to get or plan (can't get all of them together on one day) a bunch of vaccines that are good to have or update, depending on one's age/medical circumstances:

--Shingles vaccine (typically for older folks 60+), 5300b

--Hep B vaccine first of 3 shots, 580b

--Seasonal Flu vaccine, 650b

--Pneumonia vaccine (typically for older folks 60+ or those with respiratory issues), 1500b

There are various other vaccines as well, of course. But some of them Dr. Nick advised are probably not necessary for the average person living in BKK, including Japanese Encephalitis, meningitis and rabies.

The U.S. CDC, for its part, recommends a Typhoid vaccine for travelers to Thailand who are staying in smaller cities or rural areas, or, as one CDC advisory put it, "if you are an adventurous eater," which I think translates as having a penchant for eating Thai street food.

Edited July 28, 2016 by TallGuyJohninBKK

[Sheryl]

The typhoid vaccine is not very effective and the incidence of typhoid in Thailand is very low.

[simon43]

Another week has gone by and I still have a low fever and low appetite and fatigue. Otherwise, I feel fine. But one thing that I have noticed is that my urine is dark orange. I know this could be due to dehydration, but I'm drinking lots of water. Dr Google mentions that dark urine could be due to hepatitis, but that this is accompanied by jaundice, yellow skin, yellow whites of the eyes. My skin is not yellow and my eyes are white....

[Sheryl]

Simon,

Hepatitis is a consideration. The urine will be dark before jaundice is evident in the body. It iso nly when the bilirubin levels are so high that the body can't adequately excrete it that jaundice results.

Suggest you get your liver enzymes ALT, AST) and biliribin levels checked. Especially if your stools are pale in color.

[simon43]

Hi Sheryl, I checked the results slip from the hospital which mentions investigations into:

- Hepatitus B surface Antigen

- Hepatitus C Antibody

- Hepatitus A Antibody (IgM)

Plus Malerial parasites, Dengue NS1 Ag(CIE), Chikungunya IgM screening, HIV antibody

But I recall when the doctor discharged me last week that she mentioned that the test results for ALL the strains of hep had not yet come back from the lab... Perhaps I need to telephone and see if they forgot to tell me the delayed results.

Simon

[ClutchClark]

Cheryl,

Is Toxoplasmosis common over here?

I hope the OP starts recovering soon.

Of course, it is pretty much worldwide, but rarely causes disease in people who are not immunocompromised.

I was not immuno-compromised and I had Toxo.

Same for Martina Navratolova.

I only offered that possibility because my symptoms were similar and the member has come back negative on more common infections.

I would think its time to look at other the possibility of other infectious diseases.

[chubby]

In my country, the US, the vaccine is a series of tablets over a week, and is only 50% effective, and then needs to be re-done in 5 years. so, not ideal as vaccines go.; also, not easy to find sometimes

[Sheryl]

On 7/29/2016 at 8:41 AM, simon43 said:

Hi Sheryl, I checked the results slip from the hospital which mentions investigations into:

- Hepatitus B surface Antigen

- Hepatitus C Antibody

- Hepatitus A Antibody (IgM)

Plus Malerial parasites, Dengue NS1 Ag(CIE), Chikungunya IgM screening, HIV antibody

But I recall when the doctor discharged me last week that she mentioned that the test results for ALL the strains of hep had not yet come back from the lab... Perhaps I need to telephone and see if they forgot to tell me the delayed results.

Simon

It takes quite some time to develop antibodies, Hep A and C antibodies will be negative early in infection with Hep A or C. If the dark urine persists and/or jaundice develops you should either repeat those tests or get antigen tests as well as liver enzymes and bilirubin level.

[chubby]

the Hep A, and sometimes the B vaccines, are good ones, I guess the OP never got the Hep A vaccine?

[chubby]

On 7/28/2016 at 1:11 AM, TallGuyJohninBKK said:

Went by Mission Hospital in BKK yesterday for a general checkup with the American doctor there, Dr. Nick Walters. Was immediately reminded what a vastly better and more productive experience it is discussing medical issues/concerns with him vs. almost all of the Thai MDs I've encountered here, including those from some of BKK's best hospitals who have studied/trained in the west.

Took the opportunity to get or plan (can't get all of them together on one day) a bunch of vaccines that are good to have or update, depending on one's age/medical circumstances:

--Shingles vaccine (typically for older folks 60+), 5300b

--Hep B vaccine first of 3 shots, 580b

--Seasonal Flu vaccine, 650b

When is flu season in Thailand? in the US, i'm not sure getting a flu vaccine now (out of season is worthwhile), as a new vaccine should be available in about 2 months for the upcoming Sept-June season ; Hep B is usually only for those in health care or likely to be exposed to 'bodily fluids'/blood.  Shingles is apparently the one, that should be done more often than it is, if you've heard the senior horror stories, or seen some, as I have.....

Edited August 1, 2016 by chubby

[ClutchClark]

I had shingles...I would have prefered the vaccine. 

The Red Cross offers vaccines to Travelers at great prices and you can be assured the wuality of the vaccine is excellent and not some Chinese/India knock-off. Plus the nursing staff is quite professional and very well orgsnized. I far prefer it to the chaotic scenes at the local clinics. The facility is kept up to a Western standard of "clean" compared to any of the BKK hospitals I have visited.

I went there for my Rabies shots after a local Soi dog bite as well as Hep A & B "boosters" and several others. 

Its located in the old buiding (a beautiful building) next to the Snake Farm.

 

 

[TallGuyJohninBKK]

Chubby, Dr. Nick indicated in our conversation that now is a timely time to get a flu vaccine shot for the current flu season in Thailand.

Clark, I know the Red Cross does various kinds of things, but I don't know if they do the Shingles vaccine.

I'm kind of guessing, but only guessing, that they don't. Since it's pretty expensive and probably most Thais aren't going to pay for it.

 

[Sheryl]

21 hours ago, chubby said:

When is flu season in Thailand? in the US, i'm not sure getting a flu vaccine now (out of season is worthwhile), as a new vaccine should be available in about 2 months for the upcoming Sept-June season ; Hep B is usually only for those in health care or likely to be exposed to 'bodily fluids'/blood.

The above is correct for the US and Europe but not for Thailand.

 

The flu season in Thailand is now.

 

Hep B is so very prevalent in Thailand that the vaccine is recommended for all children and most adults  -- certainly anyone who might have sexual contact with locals.

[BKKdreaming]

12 hours ago, TallGuyJohninBKK said:

Chubby, Dr. Nick indicated in our conversation that now is a timely time to get a flu vaccine shot for the current flu season in Thailand.

Clark, I know the Red Cross does various kinds of things, but I don't know if they do the Shingles vaccine.

I'm kind of guessing, but only guessing, that they don't. Since it's pretty expensive and probably most Thais aren't going to pay for it.

 

 

is this the 2016 flu vaccine that would have been given in late 2015- early 2016 in the USA ?

 

or is it the newer vaccine for next year ? ,  I do not know when they switch over ? 

[Sheryl]

There are 2 different flu vaccines, the "southern hemisphere" one and the "northern hemisphere" one. The former, which is what one needs for Thailand, is available now. It is not identical to what was given in the US as there are some differences in strains of influenza between tropical countries and temperate ones.

 

People living in Thailand need only the "southern hemisphere" vaccine unless they will be in the US/Europe during the winter.

 

(I don't know what applies to Oz)

[simon43]

Finally (after about 3 weeks), I am feeling much better

 

My fever seems to have gone, my cold, clammy skin is back to a normal, warm touch and my urine is back to clearish.

 

I never found out what this fever was.  I will simply identify it in the same manner that the hospital doctor wrote on the referral slip ==> 'fever of unknown origin'.

 

But I don't want to go through the last 3 weeks again......

[siam2007]

On 17/07/2016 at 6:23 PM, impulse said:

Thanks for the info. The words I was looking for is "blood test".

For the 4th time in my 5 years in BKK, one of my friends (in this case, his Thai wife) is in an ICU barely hanging on to life because an infection wasn't diagnosed in months and months of hospital visits and spread to her brain and in her case, other vital organs.

Which hospital got it right for you?

 

what Virus / infection was identified eventually and why did it take them so long ? Do you remember what were the symptoms ?

I am in a similar situation atm, and I am being sent from pillar to post without anything actual happening or improving

[impulse]

1 hour ago, siam2007 said:

what Virus / infection was identified eventually and why did it take them so long ? Do you remember what were the symptoms ?

I am in a similar situation atm, and I am being sent from pillar to post without anything actual happening or improving

 

Welcome to the club.  The most recent lady had a staph infection that ended up with open heart surgery and several months in the hospital when they finally figured out what it was.

 

I'm reluctant to offer up any advice since I'm going through a similar situation- and have been for years- with all kinds of tests and scans and no clue what's really going on.

[siam2007]

1 hour ago, impulse said:

 

Welcome to the club.  The most recent lady had a staph infection that ended up with open heart surgery and several months in the hospital when they finally figured out what it was.

 

I'm reluctant to offer up any advice since I'm going through a similar situation- and have been for years- with all kinds of tests and scans and no clue what's really going on.

 

STAPH is what I suspect too in my case but nothing has been identified yet and the Doctors kinda ignore the STAPH thing. How got it identified eventually ? And which hospitals did fail to identify it ? government hospitals ? Or expensive private hospitals ? what were her symptoms ?

Edited April 29, 2017 by siam2007

[impulse]

Just now, siam2007 said:

STAPH is what I suspect too in my case but nothing has been identified yet and the Doctors kinda ignore the STAPH thing. How got it identified eventually ?

 

To be honest, I'm a 3rd party and not privy to the individual processes -which I figure are rather private- other than it seems they were all solved when they switched to Samitivej Hospital.  I'm headed that way once again tomorrow after giving up on the other (famous and expensive) hospital to solve it.  I've run yet another battery of tests and scans, but it's like pulling teeth to get them to look at blood, urine, sputum and stool samples- except those blood tests related to cholesterol.  Still, I'm functional albeit not 100%, and trying to be patient as they run through their recommended protocol.  Helps to have employer provided insurance otherwise I'd be eating peanut butter sandwiches 3 times a day..

[siam2007]

21 minutes ago, impulse said:

 

To be honest, I'm a 3rd party and not privy to the individual processes -which I figure are rather private- other than it seems they were all solved when they switched to Samitivej Hospital.  I'm headed that way once again tomorrow after giving up on the other (famous and expensive) hospital to solve it.  I've run yet another battery of tests and scans, but it's like pulling teeth to get them to look at blood, urine, sputum and stool samples- except those blood tests related to cholesterol.  Still, I'm functional albeit not 100%, and trying to be patient as they run through their recommended protocol.  Helps to have employer provided insurance otherwise I'd be eating peanut butter sandwiches 3 times a day..

 

The same second I read this, I have the Samitivej website open, coincidentally. Did you see Dr. Krirk Asanavatha, previously mentioned here on the board ? He has been recommended even by Sheryl, but I have not found any comment of a PERSONAL experience yet.

I have been to "other famous" hospitals too. How expensive is Samitivej compared to the likes of Bumrungrad, or even worse, BNH ? I am already buying peanut butter as I have no Hi-So insurance company behind me, just a dodgy (it seems) company that disputes virtually everything or claims these are "preconditions". Samitivej seems to only have private rooms for inpatient treatment, and very expensive which is not a good sign (even expensive Bumrungrad has semi-private or even four-bedded rooms). I am as well considering Bangkok Mission hospital or even Bangkok Christian hospital, as those are actually hospitals, and not just businesses

Edited April 29, 2017 by siam2007

[Sheryl]

As I said i nthe other thread:

 

1- your symptoms are not in any way suggestive of a staph infection, and staph infectiuons are not at all hard to diagnose. Persisiting in this vein is going to only waste time.

 

2 - it is not clear what type of specialist you need as there are non-infectious disease causes possible for your symptoms.

 

Please provide the additonal information I requested in the other thread - and drop this "staph" business once and for all, it makes no medical sense and wastes money and time. If you had a current staph infection you would have (10 fever (20 elevated white blood count and (3) clinical signs such as a visible skin infection etc. You have none of these. You have rather excessive sweating which can have a very wide range of causes, none of them the one you have decided on.