Hiatal hernia + 3 fractured vertebrae = pain/fear for life

[Sheryl]

3 hours ago, sailorjon said:

....

 

Sheryl, do you or anyone else here know exactly what procedures the pulmonary doctor is likely to do to check for lung/chest problems that might be connected to the shortness of breath?   tx.

....

 

Physical exam (listening to your lungs)

Chest Xray (if you have a recent one, bring film with you)

Pulmonary function tests (things like having you inhale and exhale using machines that measure the  air volume

 

[sailorjon]

tx. 

[sailorjon]

 

if the connection to sob is the lungs, I wonder what it is.  it was kind of sudden onset.   one week breathing ok, then boom, smallish exertion and look out.

 

ted.  I called genesis.   buy said upper g.i. endoscope about 1200, colonoscopy 1500.. roughly ,  it's not his dept but he said if he connects me with the dept maybe no communication in english,, his english is good.

 

re: clean out before, well, that's been the problem isn't it?  can't seem to get cleaned out no matter what I try.   

 

jpinx - I did the forlax but maybe not enough.  went from 2 to four packets no result then to 8 packets.   small result.  not much at all really.   Perhaps I need to do 8 packets for a number of days in a row.  I wonder if there is a cheaper alternative works the same,  the forlax sachets are not cheap.  but I'll do it.  

[perthperson]

15 minutes ago, sailorjon said:

 

if the connection to sob is the lungs, I wonder what it is.  it was kind of sudden onset.   one week breathing ok, then boom, smallish exertion and look out.

 

ted.  I called genesis.   buy said upper g.i. endoscope about 1200, colonoscopy 1500.. roughly ,  it's not his dept but he said if he connects me with the dept maybe no communication in english,, his english is good.

 

re: clean out before, well, that's been the problem isn't it?  can't seem to get cleaned out no matter what I try.   

 

jpinx - I did the forlax but maybe not enough.  went from 2 to four packets no result then to 8 packets.   small result.  not much at all really.   Perhaps I need to do 8 packets for a number of days in a row.  I wonder if there is a cheaper alternative works the same,  the forlax sachets are not cheap.  but I'll do it.  

Please note this from the Forlax data sheet ....

 

"Adults and children over 8 years
- The recommended dose is one to two sachets per day, preferably
taken as a single dose in the morning
- Start by taking one sachet each day and if needed increase to two
sachets each day
- The daily dose can be adjusted according to the effect obtained and
may range from one sachet every other day (especially in children) up
to a maximum of two sachets per day"

 

 I suggest you read the Forlax data sheet for detail. 

[Sheryl]

If you are consuming enough fiber then it may be that you have a fecal impaction. In which case you likely need manual dis-impaction in a hospital.

Diagnosis is via a simple digital rectal exam sometimes along with abdominal xray. It is not necessary to have an endoscopy to diagnose an impaction and also not possible to do one in the presence of impaction as they won't be able to visualize anything.

If I were you I'd go back to the GI specialist and tell him the laxatives haven't worked, you are still bloated, it's been a long time now and you take opoid pain killers and think you may be impacted.

[perthperson]

1 minute ago, Sheryl said:

If you are consuming enough fiber then it may be that you have a fecal impaction. In which case you likely need manual dis-impaction in a hospital.

Diagnosis is via a simple digital rectal exam sometimes along with abdominal xray. It is not necessary to have an endoscopy to diagnose an impaction and also not possible to do one in the presence of impaction as they won't be able to visualize anything.

If I were you I'd go back to the GI specialist and tell him the laxatives haven't worked, you are still bloated, it's been a long time now and you take opoid pain killers and think you may be impacted.

Before moving to the extreme of manual dis-impaction it would be worth trying an enema............ Guidance as to which enema to use should be sought from the doctor. 

[jpinx]

There is still some resistance to fixing the "simple" problem first, and allowing the more complex issues to be seen more clearly.  There are numerous ways to relieve a blocked bowel that require nothing more complex than a strong enema, a laxative at maximum dose, colonic irrigation with the standard bum-gun, and a persistence of mind to actually fix yourself without continuously thinking there is a magic bullet.

 

I asked before - are you sipping your way through 3 litres of plain warm water every day?  Have you changed your diet to remove all the problem foods and replace then with fresh vegetables, fruit, etc.?  I see fellow-patients who complain of "symptoms" and dash from hospital to hospital looking for the magician to fix them, but they still put garbage into their body -- meat, sweets, etc, etc, and worry about the cost of medication they quite likely don't need if they'd pick off the problems one-by-one.  There needs to be a fundamental change in the attitude, to accepting that one day you will die and all you're doing now is managing your health so that you will arrive at that conclusion in reasonable shape and comfort.  There is no delaying it. 

 

[perthperson]

1 minute ago, jpinx said:

There is still some resistance to fixing the "simple" problem first, and allowing the more complex issues to be seen more clearly.  There are numerous ways to relieve a blocked bowel that require nothing more complex than a strong enema, a laxative at maximum dose, colonic irriration with the standard bum-gun, and a persistence of mind to actually fix yourself without continuously thinking there is a magic bullet.

 

I asked before - are you sipping your way through 3 litres of plain warm water every day?  Have you changed your diet to remove all the problem foods and replace then with fresh vegetables, fruit, etc.?  I see fellow-patients who complain of "symptoms" and dash from hospital to hospital looking for the magician to fix them, but they still put garbage into their body -- meat, sweets, etc, etc, and worry about the cost of medication they quite likely don't need if they'd pick off the problems one-by-one.  There needs to be a fundamental change in the attitude, to accepting that one day you will die and all you're doing now is managing your health so that you will arrive at that conclusion in reasonable shape and comfort.  There is no delaying it. 

 

I have highlighted an extremely dangerous and potentially lethal. suggestion. Nothing  under pressure should NEVER be forced into the bowel. 

[jpinx]

3 minutes ago, perthperson said:

I have highlighted an extremely dangerous and potentially lethal. suggestion. Nothing  under pressure should NEVER be forced into the bowel. 

Are you a doctor?  Have you had this procedure? It's common practice all over the world. 

[perthperson]

Just now, jpinx said:

Are you a doctor?  Have you had this procedure? It's common practice all over the world. 

I beg to differ. It is a highly dangerous practice which you as an individual can indulge if you wish but you should not encourage others to do the same. 

 

Read the link 

 

http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000600012

 

[teddog]

Sailorjon may come to a conclusion it may have something to do with cancer , he states he is fed up to the back teeth of medical treatment in Thailand better for him to start a fresh approach and one that will not devour all his money.  There are doctors there that specialise in treatment he may well seek, at far less cost than Thailand

[jpinx]

19 minutes ago, perthperson said:

I beg to differ. It is a highly dangerous practice which you as an individual can indulge if you wish but you should not encourage others to do the same. 

 

Read the link 

 

http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742009000600012

 

Typically of internet medicine -- common-sense goes out the window.  *high* pressure is obviously to be avoided.  I have previously told the OP to have a helper with him whilst he takes care of these issues.

 

http://www.colonic-association.org/about-colon-hydrotherapy/

 

http://ipch.org.uk/index.php?page=colonic-hydrotherapy-explained

 

 

[perthperson]

7 minutes ago, jpinx said:

Typically of internet medicine -- common-sense goes out the window.  *high* pressure is obviously to be avoided.  I have previously told the OP to have a helper with him whilst he takes care of these issues.

 

http://www.colonic-association.org/about-colon-hydrotherapy/

 

http://ipch.org.uk/index.php?page=colonic-hydrotherapy-explained

 

 

.You advised "colonic irriration with the standard bum-gun" 

 

 I repeat shooting high pressure water from a "bum gun" into the bowel is a dangerous practice. 

[jpinx]

11 minutes ago, perthperson said:

. I repeat shooting high pressure water from a "bum gun" into the bowel is a dangerous practice. 

To re-iterate -- commonsense does not exist in internet medicine (or many other things online), and with people coming to an issue from so many highly diverse backgrounds, it is not possible to cover all possibilities.  Unless you can define "high pressure" in numerical terms of millbar, and a flow-rate to match, someone will always get it wrong.  

 

You can get an electrical colonic irrigation pump through the NHS in UK.

"........IryPump S is the only electrical bowel irrigationsystem available on NHS prescription............"

http://www.bbraun-emerald.co.uk/news-article.asp?id=38

 

Some useful commentary here for people who have enough common-sense to apply the information.

https://www.stomaatje.com/irrigation_laxatives_withoutastoma.html

 

[Sheryl]

2 hours ago, perthperson said:

.You advised "colonic irriration with the standard bum-gun" 

 

 I repeat shooting high pressure water from a "bum gun" into the bowel is a dangerous practice. 

 

Absolutely correct.

 

Under no circumstances do this.

 

As the OP's constipation has gone on for many months and is accompanied by symptoms, and as he has indicated he lacks the mobility to administer an enema, this really needs to be dealt with by a professional.  Impactions are common in people on opioids and a real impaction will not respond to enemas - the matter is rock solid, like cement. Now I am not sure thus is what he has, but it would not cost much to find out.

[perthperson]

2 minutes ago, Sheryl said:

 

Absolutely correct.

 

Under no circumstances do this.

 

As the OP's constipation has gone on for many months and is accompanied by symptoms, and as he has indicated he lacks the mobility to administer an enema, this really needs to be dealt with by a professional.  Impactions are common in people on opioids and a real impaction will not respond to enemas - the matter is rock solid, like cement. Now I am not sure thus is what he has, but it would not cost much to find out.

Thanks. I have not read the whole of this thread but would agree if the constipation is  related to opioid use the problem may demand professional intervention which may also involve/require a stay in hospital. 

[sailorjon]

6 hours ago, Sheryl said:

If you are consuming enough fiber then it may be that you have a fecal impaction. In which case you likely need manual dis-impaction in a hospital.

Diagnosis is via a simple digital rectal exam sometimes along with abdominal xray. It is not necessary to have an endoscopy to diagnose an impaction and also not possible to do one in the presence of impaction as they won't be able to visualize anything.

If I were you I'd go back to the GI specialist and tell him the laxatives haven't worked, you are still bloated, it's been a long time now and you take opoid pain killers and think you may be impacted.

I'm probably not getting enough fiber.  In fact, because of whatever is happening in the abdomen and bowels, I can eat very little without being full.  It's like a tummy tuck.  Maybe a combo of the stomach hernia? and the possible bowel obstruction/constipation.  

 

Sounds like a good idea if the GI specialist would then do something... this is dr. Piyapan who said, fix my fractured vertebrate, lose weight and get back to him.

[sailorjon]

4 hours ago, jpinx said:

There is still some resistance to fixing the "simple" problem first, and allowing the more complex issues to be seen more clearly.  There are numerous ways to relieve a blocked bowel that require nothing more complex than a strong enema, a laxative at maximum dose, colonic irrigation with the standard bum-gun, and a persistence of mind to actually fix yourself without continuously thinking there is a magic bullet.

 

I asked before - are you sipping your way through 3 litres of plain warm water every day?  Have you changed your diet to remove all the problem foods and replace then with fresh vegetables, fruit, etc.?  I see fellow-patients who complain of "symptoms" and dash from hospital to hospital looking for the magician to fix them, but they still put garbage into their body -- meat, sweets, etc, etc, and worry about the cost of medication they quite likely don't need if they'd pick off the problems one-by-one.  There needs to be a fundamental change in the attitude, to accepting that one day you will die and all you're doing now is managing your health so that you will arrive at that conclusion in reasonable shape and comfort.  There is no delaying it. 

 

I am not drinking 3 litres of water a day.  The stomach/abdomen is 'full' and hard like a basketball all the time.  eating or drinking a little packs it in more and it just becomes painfully full.  I could try again and see if peeing will keep up with the drinking.

 

I have not changed out all the problem foods for all good, healthy foods.  It's a mix.  I still eat meat.  And many days in the previous months I have no nrg for cooking and the easy way is crackers, ramen noodles,  beans in a can are good, eggs, sandwiches.    I get your point, and know bad eating and habits have resulted in these conditions and would be great if eating organic would solve it but here is also it seems to me somewhat acute conditions present that need medical intervention to solve.   To even get accurate diagnosis would be a delight.

 

I agree with accepting death and the need to change lifestyle habits.  Doing the best I can.  If 45 years of unhealthy eating and drinking could be reversed in couple months by going vegetarian I would be ecstatic.  You're a better person than I if you can make that change complete in these circumstances.   And the food  and water issue doesn't affect the breathing condition of course.

[sailorjon]

4 hours ago, teddog said:

Sailorjon may come to a conclusion it may have something to do with cancer , he states he is fed up to the back teeth of medical treatment in Thailand better for him to start a fresh approach and one that will not devour all his money.  There are doctors there that specialise in treatment he may well seek, at far less cost than Thailand

It's true.  six months.  round and round they send me for more tests, see other doctors, take these medicines, pay this bill,  and the conditions remain undiagnosed and untreated.   The last GI would have me fix my back first and lose weight for heaven's sake before we take any action to discover the cause!  this would be months and months and months of more discomfort,  He sounds like an idiot and I'm losing my patience.  And how do you lose weight quickly when your practically bedbound?  Because of the shortness of breath, Im not only not doing aerobics and marathons 3 times a week, I'm reluctant to walk to 711 and back.  

[sailorjon]

1 hour ago, Sheryl said:

 

Absolutely correct.

 

Under no circumstances do this.

 

As the OP's constipation has gone on for many months and is accompanied by symptoms, and as he has indicated he lacks the mobility to administer an enema, this really needs to be dealt with by a professional.  Impactions are common in people on opioids and a real impaction will not respond to enemas - the matter is rock solid, like cement. Now I am not sure thus is what he has, but it would not cost much to find out.

And what exactly would find out.    x-ray, or colonoscopy, or what...

My latest thinking is get endoscopy and colonoscopy and there should be some answers.

[perthperson]

8 minutes ago, sailorjon said:

And what exactly would find out.    x-ray, or colonoscopy, or what...

My latest thinking is get endoscopy and colonoscopy and there should be some answers.

Constipation with impaction is easily diagnosed by simple digital examination +/- a simple x-ray of the abdomen.

 

There would be no point in doing a colonoscopy whilst constipated and a upper GI endoscopy would be unhelpful in securing the diagnosis. 

[sailorjon]

thank you all for the brainstorming and suggestions.  I really appreciate it.  I'm pushing hard to find some place that will do something competent, effective and helpful before the money is completely gone.  I've only about 50000 left and small monthly income frankly.  Seems like it will go much farther in India than here.   It might turn out just as bad but I like to think positively and it seems like my best shot given the circumstances and a rational choice.

 

The insurance denied coverage for angiogram.  Insurance agent and I pushing for reason and they sent a request for 3 copies of authorization form to send to hospitals for medical records.  s.o.p. to find out if the condition started before I got the insurance with was April 10.

 

Today the broker forwarded a letter to me from the CEO of Pacific Cross.  It's on a par with this whole fiasco.

 

The answers to his queries are:

a. I don't know why the records he is looking at say 148cm.  I am not 4'8" tall, I am 5'3" or 4" tall

b. The reason I didn't declare Diabetes on the application is because Diabetes was diagnosed for the first time last month while getting the heart check at Vejthani.    BTW, I honestly disclosed all conditions I knew about on the application which is why treatment for the hiatal hernia, fractured vertebrae and hypertension are excluded.

c. I never provided a copy of medical records from the usa to hospitals here.   

 

So, given the tone and content I don't put a lot of hope in the insurance I purchased coming through here.

 

[sailorjon]

ok, but doesn't that leave the rest of the intestines that are deeper than finger length unexamined for problems?

[teddog]

If the quacks got paid by results here in Thailand they would probably owe you money at the end of the month.  That hospital in India  ,the last one,soundsOK, not on the tourist trail, Genesis,   600 and 750 baht for up the ass/down the throat,endoscopy/colonoscopy,seemsOk, with what I've seen quoted here in the past, thought I saw one estimate at 32000 baht once for endoscopy here in Thailand, you will be in and out in little over 40 mins there in India, and if there is blockage, can ask them to investigate. 

  Did look at the hospitals there that would deal with your complaint,I'll send them if you consider going over, other benefits going over , get good glasses at a fraction of Thailand prices, few other things too.  Wasting your time staying here Sailor, you should know it by now

 

 wasting your money on medical insurance Sailor,another dead end

[sailorjon]

4 minutes ago, perthperson said:

Constipation with impaction is easily diagnosed by simple digital examination +/- a simple x-ray of the abdomen.

 

There would be no point in doing a colonoscopy whilst constipated and a upper GI endoscopy would be unhelpful in securing the diagnosis. 

Ok, but wouldn't that leave the rest of the intestinal track that is deeper than finger length unexamined for problems?

[sailorjon]

2 minutes ago, teddog said:

If the quacks got paid by results here in Thailand they would probably owe you money at the end of the month.  That hospital in India  ,the last one,soundsOK, not on the tourist trail, Genesis,   600 and 750 baht for up the ass/down the throat,endoscopy/colonoscopy,seemsOk, with what I've seen quoted here in the past, thought I saw one estimate at 32000 baht once for endoscopy here in Thailand, you will be in and out in little over 40 mins there in India, and if there is blockage, can ask them to investigate. 

  Did look at the hospitals there that would deal with your complaint,I'll send them if you consider going over, other benefits going over , get good glasses at a fraction of Thailand prices, few other things too.  Wasting your time staying here Sailor, you should know it by now

Yes, please send.  I am trying to do it. And yes, I know it now.   

[perthperson]

1 minute ago, sailorjon said:

ok, but doesn't that leave the rest of the intestines that are deeper than finger length unexamined for problems?

Believe me when I say you are overthinking this issue. As said chronic constipation with impaction is easily diagnosed by a professional using the simple techniques I have described. I would be impossible to undertake a colonoscopy whilst constipated. The examination would fail and you would still be required to pay the bill. 

 

I have noted your anxiety about funds and the problems with insurance. 

 

Have you considered returning to your home country where it would be easier to sort your problems.? 

[Sheryl]

Yes, but the impaction will usually be within finger's reach (lower end of it anyhow). It is in the colon that stool hardens.

 

Regarding the insurance company letter:

 

1 - Apparently your height is incorrectly recorded on one of the hospital records. If you are 5 feet 4 inches that is about 164 cm.  It is NOT 168 cm. Suggest you clarify to them your actual height. It makes a difference as 148 cm is quite short and whatever your weight, at that hieight you'd likely be morbidly obese.

 

2. I beleive you aid that the check up showed only pre-diabetes? You need to clarify that to them and also that it was a new finding.

 

3.They want records from the US to be abel to have something that substantiates how long you have had your SOB and possible heart problem. It is irrelevant that you never provided those to the hospitals in Thailand, the point is they are looking for documentation of your prior state of health.

 

I suggest you reply to them as per above. I very much doubt they will pay for the angiogram, since your SOB did predate the policy and heart disease takes years to develop. but it may help preseve your policy as from the tone of the letter the whole thing may be in peril. Witholding or mis-stating information is grounds to void an insurance policy.

 

 

[sailorjon]

Just now, perthperson said:

Believe me when I say you are overthinking this issue. As said chronic constipation with impaction is easily diagnosed by a professional using the simple techniques I have described. I would be impossible to undertake a colonoscopy whilst constipated. The examination would fail and you would still be required to pay the bill. 

 

I have noted your anxiety about funds and the problems with insurance. 

 

Have you considered returning to your home country where it would be easier to sort your problems.? 

tx, good information.  I will ask them first to check then for impactation and provide a solution to clean out the crap and then, if necessary, can do the colonoscopy.  I will need help, I can't do the enema, etc. alone and have no helpers for this task at this time.

 

Returning to usa is not  possible and not a solution.   I have no family alive there anymore.  It's not a place you want to land with $10 in your pocket.      Besides that, and that is a big issue, how to survive without money for housing transportation etc, who knows what help will be available if the  nightmare health care bill they are trying to pass goes through.  My demographic is the hardest hit.

 

[Sheryl]

5 minutes ago, perthperson said:

Believe me when I say you are overthinking this issue. As said chronic constipation with impaction is easily diagnosed by a professional using the simple techniques I have described. I would be impossible to undertake a colonoscopy whilst constipated. The examination would fail and you would still be required to pay the bill. 

 

 

 

Exactly correct. 

 

If you believe that going back to the GI doctor yo usaw before and telling him the laxatives he prescribed did not work and asking to be examined for possible impaction will not work, then see a different doctor. Though I believe the part about fix the spine and loose weight first was in regard to your request for hh repair, not the constipation. He gave you medication for that, it did not work but he does not know that as you never went back.