Questions to general practitioner Maarten
Maarten Vasbinder lives in Isaan for 1½ years, where he met a wonderful woman with whom he shares joys and sorrows. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers and writes about medical facts.
Do you have a question for Maarten? Send this to the editor: www.thailandblog.nl/contact/
Dear Martin,
I (like many falangs) had an infection in one of my legs, result: lower leg completely red and swollen. I've had this 3 years in a row, always sometime in June (start of rainy season). The first time to a private clinic, immediately admitted, on a drip, antibiotics, etc. Duration 6 days. The doctor told me that I would probably come back again, I have a bacteria in my blood which apparently cannot be completely eradicated rowing is. And yes, the following year the same problem, only on my other leg, a small wound or inflammation, and it is immediately price. The costs are somewhere around ten thousand baht per day for withdrawal, so that cuts into it. Now : I handed over the entire case, including invoice and treatment, to my GP in the Netherlands, with the question: Does this doctor have the right treatment method or. antibiotics applied. Answer from my doctor: If you have something like this going on again: Fludoxacillin 4xdaily 500mg.
Now my question to you: Is it worth trying this risk? Can I stock up on this medicine in advance?
I have already seen this infection in at least 6 of my phalang contacts here.
I would be happy to send any photos for information.
Regards,
L.
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Purchase.,
You probably have erysipelas. It is also often referred to as cellulite, although that is not exactly the same thing. However, the distinction is difficult. Not to be confused with cellulite, the orange peel skin on the upper legs in many women.
Erysipelas is a serious bacterial infectious disease of the skin and subcutaneous fatty tissue. This can occur through a wound in the skin and is common in people with lymphedema, in people with a bypass for which a vessel from the lower leg has been used, in athlete's foot (the wound is often between the toes), in diabetic patients, in poor circulation (smokers) and also in overweight people.
The causative agent is usually a streptococcus or staphylococcus, which has entered through that wound.
Unfortunately, erysipelas is often difficult to treat and can therefore take on a chronic form. In that case, it will come back again and again. The warmer, the more likely the symptoms will return.
Of course I don't know how you have been treated here, but flucloxaciline is an excellent antibiotic and often effective. Take it for at least two weeks.
The professor of internal medicine I had in the training claimed that after 20 weeks of taking it there is a chance of a cure. However, that has never been proven.
Isolating the bacteria will also help, although it is very difficult in this case.
Very important is good hygiene, also between the toes, to prevent new bacteria from entering.
In case of a high fever, always consult a doctor, but preferably before that, to avoid serious complications.
Photos are always helpful when giving advice
Yours faithfully,
Maarten
Hello Maarten,
I have had a herpes virus infection for 20 years that came back in my face 3 to 4 times a year in the Netherlands. Now that I have lived in Thailand for a number of years, the infection comes back much more often, 7 to 8 times a year.
The reason would be heat stress and that may be true because the virus returns the most from March to November.
What to do? Live in air conditioning, accept or return to the Netherlands.
All 3 not an option, I love Thailand and the outdoors, so I don't have air conditioning at home. So please advise how to deal with this.
Ps am a moderate drinker, still reasonably active and otherwise healthy
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Specifications.,
My suspicion is that this is Herpes Simplex I.
The only thing I can recommend is to take a course of Valaciclovir 2dd500mg for 10 days at the next outbreak of the virus.
Then 1 tablet per week to prevent a new infection. I have had great success with this in my practice.
Other anti-viral drugs are of course also possible.
Be sure to discuss this with your own doctor first.
Yours faithfully,
Maarten
Dear Martin,
Since 2004 when my holidays in Thailand started, I obediently got the injections that were considered "necessary". Did that until 2010 and from that moment on I went to live in Thailand and stopped doing this.
My question is whether you should do something about it here in Thailand or whether you say, never mind.
Thank you in advance for your answer.
Regards,
D.
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Dear D.,
Of course I don't know what injections you have had, but I advise you to continue with them. Each vaccine is repeated at a certain frequency. That frequency is within a safe margin.
Yellow fever 10 years, but that vaccination probably works for life.
Important in Thailand are diphtheria, whooping cough, polio (still), possibly yellow fever and typhus. A good addition are hepatitis A and B. Meningitis A and C and soon B.
An injection against pneumonia also has its advantages. A vaccine is on the way for melioidosis (a very dangerous pneumonia), which is common in Thailand.
There will also be a Dengue vaccine in the near future, which is currently being tested on school children in Cambodia and Thailand, among others. If I forgot something, let me know.
To be honest, I've stopped all those injections myself, but I can't advise anyone to do that.
With kind regards,
Maarten