[Where To Watch Rugby World Cup In Khorat]

Help, my friend is living out in the country near Chattarat and wants to watch rugby world cup. He has been out of the country and did not have the chance to check this out ahead of time. If he goes in to Khorat, which bar or restaurant will be showing the games? He is Irish if that makes any difference.

[Import Tax On Golf Clubs]

I realize that this topic has been covered a bit before but I am still muddled. My husband is trying to decide if he should have a new set of golf clubs (generic brand copies of the real thing) plus bag shipped to Chiang Mai or if he should wait and buy them in the states next summer and bring them back. (He has clubs here now but they are VERY old.) The cost of the clubs plus bag is $490 and the cost of shipping is $125. I understand that the import tax/duty tax/ customs charges are not set in stone but if anyone can give us an idea of a ballpark figure or an example of their own experience it would be very helpful. Thank you.

[Cancer Treatment Experience In Chiang Mai]

Returning to the topic: if I get cancer and wish to be treated by something more effective than dried rhinoceros penis extract, can I get treated here or should I hop on the next plane to Houston and M D Anderson?

I, too, think that the above is the main issue. It seems to me that the tools (medicines and machines) are here, and the doctors are here. It was my friend's experience that they were not put to use in an efficient manner. Was she merely unlucky or was her experience the norm? Doing the research on the internet while ill is difficult and the information is targeted towards people receiving treatment in western countries. Can readers here offer some help for those yet to be in this dilemma?

As for alternative treatments, my friend wanted to try the organic flaxseed oil and cottage cheese diet but she found that actually getting her hands on truly fresh oil here might be impossible. Also, by this point, her energy and motivation were rapidly declining due to the cancer and the effects of the treatment.

Another point raised by a poster was that of hospice. We were not able to find anything that resembles the western notion of hospice here that is available for cancer patients except a bed in a hospital at the very end. What are the alternatives? If any of you can shed light on these issues I think it may help others.

[Cancer Treatment Experience In Chiang Mai]

Last spring I wrote a blog concerning the steps to be taken after someone has died at home. I appreciate all of the kind sentiments expressed in responses. My friend was not happy with the medical treatment that she had received and I promised that I would write about her experiences in the hopes that it might help others. Already one person has responded with information regarding pain medication that I wish we had known and I hope that this blog will spark more such information. This letter is long so I have put my suggestions in bold print for a quicker read. Please respond with your own experiences and advice for others.

1. Getting a diagnosis: It took my friend more than 6 months to be diagnosed. She went to McCormick, Chiang Mai Ram, Suan Dok, and the clinic on Loi Kroh. While she herself suspected lung cancer she was quick to accept the reading of an x-ray that stated "all clear". She was given numerous diagnoses and she purchased and took lots of medications and followed special regimens. She spent a week in Ram and was discharged with a diagnosis of depression, cervical spondylosis and kidney disfunction. Suggestions: Do the research on your symptoms. If you are suspicious don't take "it's clear" without asking for another opinion or x-ray. It is so tempting to accept a "no cancer" statement. Be tough! Also, take notes! It is next to impossible to remember what everyone said at a later date. If possible have a friend or family member do this for you so that you can concentrate on being freaked out... I mean, in control.

2. Diagnosis: When my friend returned to Ram a few months later with her face and neck hugely swollen, she was given a ct scan. The supervising doctor then took me aside and told me that my friend had a 10cm tumor on her bronchial tubes. It was up to me to tell her the news. The oncologist came for a visit and urged her to get a biopsy done ASAP. This was done and though it was a very painful procedure the skillful surgeon was able to remove a portion of the tumor that was causing much of the pain. The next morning the oncologist returned with the diagnosis of small cell lung cancer and urged immediate treatment. We asked for information on side effects, costs, time-tables, remission rates, etc. The information we were given was vague and at times misleading. My friend felt rushed but agreed to begin treatment the next day. Suggestions: don't wait so long to demand attention. My friend had suffered greatly thinking that the doctors she was seeing were doing the right thing. If you want to be an active part of your treatment plans tell the doctors from the first that you want them to tell you the diagnosis and not to filter it through family and friends. Really try to get the oncologist to play it straight with you. Ask for the names of medications and the side effects, the time tables, the costs. It would be best if the doctor had some printed material to give you but this was not our experience. Try to get some realistic idea of the remission rates and the possible cure rates. Once again, write it down! Don't be rushed, if you have a way to get more information or advice, take the time to get it.

3. Chemo: Treatment at Ram began the next day. From the first it became clear that each treatment would take longer than we were told. Also, once the I.V. began flowing I was left alone with my friend. When I asked what to do the nurses gave me a plastic bag and said to call if there were any problems. Everyone tolerates chemo differently so be prepared. My friend was greatly bothered by some of the routine procedures such as the insistence that the I.V. must be put in the back of the hands and repeated interruptions during the night. Checking out took hours and required a careful eye on the final bill. Suggestions: Be assertive (not aggressive, don't yell!!), allow double the stated time for each procedure, try to get the nurses to not come in during the middle of the nights. Double check the medication list that you will pay for at check-out ( also, many of the medications can be obtained at pharmacies for much less), check to see if you qualify for the senior citizen discount and then get it, make all necessary appointments for home check-ups etc, get the necessary phone numbers and email addresses. (email can be a hassle through Ram as you email a central clearinghouse and then the message goes to the doctor and the doctor's answer goes back to the clearinghouse and then to you. Also, we were not given a phone number for the doctor in case of emergencies or questions). In other countries chemo can be given on an outpatient basis in certain cases. Ram did not offer this but perhaps with pressure it could be set up in the future. Once you are home get back on the internet to help prepare you for the side-effects of the chemo, as there will be some, if not many.

4. Home health care: A nurse, who brings along a few others, will be assigned to visit the home during the 4-5 weeks between treatments. Their main function is to take blood to document the fall and hopeful rise of red and white blood cell counts. They also take temperatures, check for swollen ankles, ask a few questions and little else. The doctor should let you know your status either by phone or email. Suggestions: Make sure that the home care personnel wash their hands when entering your home. After chemo you are very vulnerable to disease and some of the home care people don’t appear to understand that they are the possible germ carriers, not the patient. Set up meal delivery if necessary as there will be days when you will not be able to go out. Make sure that there is a clear line of communication between you and the doctor and the home care nurses.

5. Radiation treatment: My friend travelled to Suan Dok and then walked down into the basement for her radiation treatment. While it was crowded she seemed to be given preference and usually was seen shortly after her appointment time. She was able to speak with the radiologist several times. Her dignity and comfort were not always a priority though and she occasionally was left, chest bared, on the table while the machine was retooled. At one point her chemo treatments and radiation treatments overlapped and there were problems getting finished with chemo in time to make her radiation appointment. There appeared to be some disagreement between her oncologist and radiologist over medications the one time that they spoke on the phone but the radiologist appeared to defer to the oncologist. Suggestions: Hopefully your oncologist and radiologist will work together. Our experience was that as the radiation must be done at Suan Dok (the only place in town I think) and the oncologist was at Chiang Mai Ram, there was little to no communication between them. It may be better to do all of your treatment through Suan Dok in hopes that the two doctors will communicate on a regular basis. Also, be aware of which doctor appears to be “in charge” as the other will likely defer to them. As radiation is on an outpatient basis, set up transportation and preferably some company. You might go in feeling OK but come out quite whoozy and need a supporting arm.

6. Other tests and treatment. My friend was put through multiple tests during all of this. Were they all necessary? I don't know. She was also strongly urged to get prophylactic brain radiation once she was declared in remission, which she did. During this time of supposed remission she began feeling quite ill again. She hoped that she just could not tolerate the radiation but thought that it was probably her cancer. In less than 3 months she was back at Chiang Mai Ram. She had a visible tumor in her neck and a ct scan of her chest showed several more. She refused more treatment and she died, at home, not long after. Suggestions: Whether you are the patient or helping someone else go through this, it is a stressful business. Try to get as much information as possible, document everything, be assertive, do not let dignity get lost in the quest for a cure, don't shut out others, and find the little joys in each day. Best wishes.

[Permanent Hair Straightening In Ch Mai?]

My mom is in town and would like to get her hair permanently straightened. She said there is some Japanese method that is supposed to work well. Can anyone recommend a reputable salon in Ch. Mai where she can have this done?

thanks!

mp413

I get my hair done using the Japanese method of rebonding at "Absolute" on Huay Kaew Road. Your mom can find cheaper places but I found that because of the volume of westerners using that salon that they understand the thinness and fragility of some of our hair. Does your mom understand that once she has this proceedure done it will need to be repeated every 6 months or 1 year depending on her rate of hair growth? The proceedure is quite long, up to 4 or 5 hours and she will not be able to get her hair wet for 3 days. Also if she colors her hair this can further damage it. I recommend that she do some research on the internet before taking this step. Having said that, I have been quite happy with the results and have been having my hair done every 6 months for about 4 years. Best wishes and have lots of fun with your mom.

[Dying At Home In Chiang Mai]

"For your information : I had no trouble whatsoever getting Fentanyl transdermal (skin) patches during the intensely painful period following radiation therapy which lasted about six weeks.

I hope this information will be useful to you, or someone else here on TV." orang37

Thank you. I wish that we had known of this medication. I am sure that someone will benefit from your post, especially your recommendations for an oncology doctor and the cancer clinic. (Can my friend have a "do over"?) Best wishes with your health. T57

[Dying At Home In Chiang Mai]

TRAZ57, are you able to tell us much about how the woman's pain management was handled?

I think that is something of much concern to all of us; for ourselves as well as for others.

When I can get my head together I will write about the treatment she recieved. I wish that I could say that pain management was sufficient, but it was not. Her son was able to bring some prescription drugs from the states that helped some. The doctor here was willing to prescribe some morphene but in small amounts. There is strong paranoia regarding morphene here, as if terminal patients can become addicts!

[Dying At Home In Chiang Mai]

I am going to pin this topic & if the op doesn't mind amend the subtitle to "Information on what to do for next of kin"

I am just learning how to work this forum so I hope this is the correct way to respond.

Of course, please change the subtitle if that will make the information more accessible. My friend who passed away was big into getting information out. She wrote several books over the years that were quite useful so this is all in her name.

[Dying At Home In Chiang Mai]

I recently lost my very good friend. She died of cancer at home here in Chiang Mai. Her son came from the U.S. to spend her last weeks with her and I promised him that I would post this information to help others deal with the particulars while they are having to deal with the pain of loss. Because, as the terminal diagnosis became an unavoidable reality we began to try to find information on what procedures should be followed when a falang dies in Chiang Mai. There was very little information to be found. The following is our experience of the steps to take following a death at home. ( One day, I hope to put some information regarding the whole treatment experience but that is for another time).

The evening my friend passed away her son called for an ambulance from Chiang Mai Ram (where she had been under the care of an oncologist). The ambulance arrived but, as she had already passed, they said that the police must be called first as it was a death outside of the hospital. The ambulance then returned to CMR. When the police arrived there was a lot of confusion. Luckily a Thai friend stepped in and explained that the deceased had been very ill with cancer for a long time. (At this point and from now on it is very important to have the passport of the deceased.) The police asked her son if he wished for an autopsy to determine if it was actually the cancer that had killed his mother. He declined. The police took a report and took a picture and allowed the son to call for another ambulance. The ambulance transported the deceased to the hospital and allowed the son and me to ride with the body.

At the hospital the body was placed in a refrigerated unit in the morgue (quite a small, informal area). The son was advised to contact the police to pick up the police report in the morning (the hospital verified which police station to go to) and then to contact the British Honorary Consulate (she was British). We were offered a ride back to our homes.

The police report was quickly obtained for no charge. We then went to the British H. Consulate where the son was treated with great kindness. The son had a birth certificate showing that he was next of kin. He was asked if there were any other relatives that should be involved with funeral arrangements. Copies were made of passports, birth certificate, and the police report. A letter was typed certifying that the son was the next of kin and was able to make funeral arrangements. He was advised as to which municipal office he needed to proceed to in order to get a death certificate. It must be the office in charge of the area in which the person died. There was no charge for any of this.

We encountered our first small glitch at the municipal office. The forms are in Thai and you will need someone who can read and write Thai to help you fill them out. We were very lucky as a young woman on her break from work offered to help. The death certificate was obtained in a short time and copies made.

The next step was to go to the temple. We had chosen Wat Pa Paeng. We had not spoken to anyone officially before this, however, as they won't make arrangements without the death certificate. By now we had been joined by a friend who speaks fluent Thai. (Very necessary at this point.) There was a Thai gentleman at the wat who spoke with us and within 30 minutes the arrangements had been made for a simple Buddhist cremation for the following afternoon. The price for the ceremony was 5,000 baht to be paid in an envelope before the ceremony. Another 200 baht would be paid when the remains were picked up on the morning following the funeral.

We then proceeded to the hospital where we made arrangements for an ambulance to take the body to the wat the following afternoon. We also requested to have a change of clothes put on the body. This was all arranged easily. However, if you bring a change of clothing be sure that the items have buttons or closings that allow it to be put on a stiffening body, Sliding clothing over the head or feet may not work.

At the appointed time the following day we arrived back at the hospital and paid a small fee for the all of the hospital services (several ambulance rides and storage in the morgue, 600baht).The body was wrapped in a white sheet and we accompanied it in an ambulance to the wat. The body was placed on a wooden tray. Monks chanted and performed a simple ceremony. Family and friends were allowed to place flowers (usually wreaths in Thailand) on the body and to say good-bye. The crematorium was opened and the body was slid inside. After waiting for the boy and girl scouts who were practicing drills in the temple yard to finish, the crematorium was lit. The ceremony was over and the friends and family retired to a local café to tell stories and toast the deceased.

The following morning we returned for the remains. Thinking that the son would be given ashes with bits of bone we were surprised to be greeted with a pile of bone on a metal tray. Some pieces were longer than 10cms. Later we learned that it is the bones that are important to the continuing ceremonies for many Asian cultures. If you want some ashes you may be able to arrange something different before the ceremony but I don't know if they are equipped to gather the ash. We were given a plastic bag to collect the bones by hand. We were instructed to wash our hands after doing this. The son was given a receipt from the wat for the bones.

Before leaving the country the son was advised to get the death certificate, the police report, and the receipt for the bones translated into English. This can be done through the consulate but that entails days of waiting and piles of baht. He was able to use a local translating service. He was advised to hand carry the remains along with the proper paperwork. He was not questioned upon leaving Thailand or entering the U.S. so the validity of the paperwork was not called into question. .

All that remains now are the memories and the hole on the soi where this wonderful woman resided. She is missed on many continents. It would be her wish that her death could be informative to others. In death, as in life, she is an inspiration.