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BANGKOK 27 March 2019 01:29
melvinmelvin

Legs swollen out of proportions (cellulities)

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Congestive Heart Failure usually  refers to the consequences of decreased pumping efficiency of the left side of the heart with resulting accumulation of fluid in the lungs.  Your left side function, from what you report, is normal.

 

You have what is termed right sided heart failure, common in COPD. In this case there is usually no accumulation of fluid in the lungs but rather in the veins.

 

To understand this you need to start with the basic anatomy and physiology. Blood from all over the body is returned to the heart via veins. It enters the right side of the heart and from there is pumped to the lungs for re-oxygenation. From there is goes back to the left side of the heart which then pumps it out to the body via arteries. 

 

In your case due to lung disease there is resistance to the travel of  blood from the right side of the heart to the lungs. So the right side of the heart is pumping against resistance, which puts a strain on it. It also creates a backlog of blood (congestion) not only in the right heart chambers but also in the veins.  Due to gravity the effect of the congestion in the veins will be most noticeable in the legs and feet.

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2 hours ago, Sheryl said:

Congestive Heart Failure usually  refers to the consequences of decreased pumping efficiency of the left side of the heart with resulting accumulation of fluid in the lungs.  Your left side function, from what you report, is normal.

 

You have what is termed right sided heart failure, common in COPD. In this case there is usually no accumulation of fluid in the lungs but rather in the veins.

 

To understand this you need to start with the basic anatomy and physiology. Blood from all over the body is returned to the heart via veins. It enters the right side of the heart and from there is pumped to the lungs for re-oxygenation. From there is goes back to the left side of the heart which then pumps it out to the body via arteries. 

 

In your case due to lung disease there is resistance to the travel of  blood from the right side of the heart to the lungs. So the right side of the heart is pumping against resistance, which puts a strain on it. It also creates a backlog of blood (congestion) not only in the right heart chambers but also in the veins.  Due to gravity the effect of the congestion in the veins will be most noticeable in the legs and feet.

thanks an awful lot for all this feedback

 

your piece above, very well put and fairly precise I think, (you should consider getting into teaching)

 

what you write above is pretty much exactly how I understand it

(couldn't write it down that clear though)

 

I will now focus on, healthy low sodium diet (which I already do), not getting severe colds or pneumonia,

, getting phlegm out of the way, sound exercise, O2 while sleeping

 

to add some precision re my lung specialist doctor in Norway and exercise

(yes doctor - not phd - the real thing)

moderate exercise you should do - daily - good for you - muscles etc etc - the whole body

however, moderate exercise will not improve lung capacity or gas exchange,

very hard aeorobic exercise may result in some improvement re lungs

your heart seems to be OK for it

over the past 10 past years we have registered improvements in the yearly tests during periods

in which you have been physically very active.

 

thanks again

 

 

 

Edited by melvinmelvin
precision

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Guys,

prices on medicines, Siriraj versus high street

 

Today I bought 1 month supply of medicine for my this and that.

 

Last week I also bought a wee bit here in Bang Yai/Nonthaburi, local yaa-shop.

 

Prices below are in Thai Baht, I have calculated price per 1 pill/tablet/met.

 

Today I purchased yaa in the soi next to Siriraj

the soi goes from Arun Amarin and down to the river, packed with street food stalls and yaa-shops.

next to Siriraj, southern side, cheapest place in BKK for medicine I think.

 

1) Vessel 250 LSU (sulodixide)

   SOI                   32.33 / met

   SIRIRAJ             62.5 / met

 

2) DAFLON 500 mg

   local                 9.66 / met

   SOI                   8.6 / met

   Siriraj                20.0 / met

 

3) Reparil Dragees 20 mg

    SOI                   4.66 /  met

    SIRIRAJ             8.75 / met

 

 

guess one could safely synthesize that Siriraj ain't no give away

 

Interesting debate in LoS now,

re government and yaa price controll

 

 

 

 

 

 

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21 minutes ago, melvinmelvin said:

 

Guys,

prices on medicines, Siriraj versus high street

 

Today I bought 1 month supply of medicine for my this and that.

 

Last week I also bought a wee bit here in Bang Yai/Nonthaburi, local yaa-shop.

 

Prices below are in Thai Baht, I have calculated price per 1 pill/tablet/met.

 

Today I purchased yaa in the soi next to Siriraj

the soi goes from Arun Amarin and down to the river, packed with street food stalls and yaa-shops.

next to Siriraj, southern side, cheapest place in BKK for medicine I think.

 

1) Vessel 250 LSU (sulodixide)

   SOI                   32.33 / met

   SIRIRAJ             62.5 / met

 

2) DAFLON 500 mg

   local                 9.66 / met

   SOI                   8.6 / met

   Siriraj                20.0 / met

 

3) Reparil Dragees 20 mg

    SOI                   4.66 /  met

    SIRIRAJ             8.75 / met

 

 

guess one could safely synthesize that Siriraj ain't no give away

 

Interesting debate in LoS now,

re government and yaa price controll

 

 

 

 

 

 

I am more interested to know how you are not.. almost 2 months later. Have things cleared up or not ?

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4 minutes ago, robblok said:

I am more interested to know how you are not.. almost 2 months later. Have things cleared up or not ?

 

thanks

improving by every two days now

me thinks

 

 

 

 

Edited by melvinmelvin

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On 1/18/2019 at 11:28 AM, melvinmelvin said:

 

thanks

improving by every two days now

me thinks

 

 

 

 

to continue on that, have improved a lot, both legs are down to normal size from knee and down,

still a bit biggish above the knee, but nothing like before, can easily get into my chaole pants now.

 

body fluid still seeping from left leg, but very very moderate amounts, compared to before

 

skin on the legs below knee, was absolutely disgusting before, better now,

have done some treatment with steroid cremes

(I still prefer waring chaole rather than kassan If a go to a restaurant or similar, people stare)

 

oxygen saturation up from 91/92 to 96, works for me, have some power, can walk,

can go shopping BigC etc, can work a bit with my hobbies.

 

think the improved oxygen saturation is partly due to me trying to put in a few hours of

breathing oxygen every day (have 1 big and 1 small tank at home),

but more importantly due to me having completely changed the way I am breathing

compared to earlier,

the lung specialist at Siriraj says that I am now breathing in a way that to a large extent

ensures that "dirty air" is not left in the lungs but exhaled every time

(deep in through nose, exhaled relatively slow through partly closed mouth)

 

 

but time it takes

 

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Must say I am pretty comfortable and pleased with the physicians at Siriraj.

My feeling is that they are very competent, (my academic background is lightyears from medicine),

but my gut feeling tells me that they are pretty good.

 

Command of English varies, but with some Thai from me it works out.

They have time and are very good at explaining what is not working as it should

and why and what could be done. They take time to draw sketches and explain.

 

I now have a reasonably good (I think) understanding of what, and why, is going in my body

re worn out lungs - veins - gas exchange in the lungs - oedema - fluid congestion etc.

 

---

Don't much like buying medicine at Siriraj though (or any hospital in Thailand for that matter).

One aspect is gross over pricing, Siriraj not really better than others, (I made some illustrations above).

For me, the really bad part is that a Thai hospital just give me some plastic bags with pills inside,

no information about what the medicine is for

no information about how the medicine works

no information about chemical composition

no information about side effect.

I really dislike this. I prefer to know what I am eating.

If I buy the same in a medical shop I get a proper package  and

I get a comprehensive information leaflet with information about the medicine.

 

I do prefer the latter.

 

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there are some good large pharmacies right near Siriraj, buy your meds there

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30 minutes ago, Sheryl said:

there are some good large pharmacies right near Siriraj, buy your meds there

thanks, I do that, I have already posted about that above

 

From Arun Amarin road and down to the Chao Praya river, along the southern perimeter 

of Siriraj runs a relatively small soi,

 

packed with pharmacies and medical supply shops and street food stalls

 

I reckon pretty much the cheapest place in Bangkok to buy medicine

 

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