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  1. #1
    The Fool on the Hill bowie's Avatar
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    Cancer Treatment in Thailand

    Just some food for thought of general interest. Found this on a Luma Health Insurance website (yup, they are soliciting for Expat insurance business)

    The numbers are somewhat dated – 2013, but the information is reasonable providing cancer and treatments in Thailand.
    https://blog.lumahealth.com/cancer-t...edium=referral

    Cancer treatment in Thailand
    Cancer treatment among Thai citizens are covered with the three main health care schemes. However, certain treatments and medications must be privately paid for.

    In general, the cost of treatment in Thailand is
    lower than some western countries and the United States. Especially room rates and nursing service are cheaper (including stay in intensive care or coronary care units). Staying in a comfortable hospital room in one of the reputable hospitals in Bangkok will actually cost about the same as staying at a five-star hotel.

    When it comes to cancer treatment, prices vary dependent on the treatment choice such as, surgery, chemotherapy, hormone therapy and radiotherapy. Types of cancer is also a key factor in price variations. However, it is remarked that costs in public hospitals are usually 30-40% lower than that in the private ones.

    According to King Chulalongkorn Memorial Hospital, one of the national leading cancer centres, approximate cost of radiation therapy in common cancers are listed below:

    • Breast cancer: 69,300 - 84,500 baht
    • Cervical Cancer: 145,000 baht
    • Lung cancer: 141,100 - 197,600 baht
    • Prostate cancer: 182,400 baht
    • Colon cancer: 103,000 baht

    *Prices are subjective to change. Please contact the hospital for further details.www.chulacancer.net

    Meanwhile, private hospitals, especially those oncology-specialised hospitals, offer the state-of-the-art technology, facilities, and international-standard services at far higher rates.

    According to Roche’s data in 2013, estimated cost for different treatment methods and cancer stages are as follows:

    Treatment approaches
    Early stage (price in baht)
    Metastasis (price in baht)
    Diagnosis
    27,000
    27,000
    Surgery
    200,000
    -
    Hormone
    -
    -
    Radio
    200,000
    200,000
    Chemo
    350,000
    -
    F/U
    110,000
    350,000
    Supportive Care
    360,000
    360,000
    Palliative Care
    -
    300,000
    Targeted
    1,650,000
    2,935,000
    Total
    2,512,000
    4,172,000

    Remark: End-user price estimation at Bumrungrad hospital, June 2013

    Cancer Treatment Approaches
    Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. It is normal to feel overwhelmed and confused with the treatment options and choices to be made. But,
    talking with your doctor and learning about the types of treatment you may have can help you feel more in control.

    Surgery
    When used to treat cancer,
    surgery is a procedure in which a surgeon removes cancer from your body. Depending on your type of cancer and how advanced it is, surgery can be used to remove the entire tumor, parts of a tumor and used to ease cancer symptoms.

    Radiation Therapy
    Radiation therapy is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. This method not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. That means, this can damage to healthy cells and cause side effects.

    Brachytherapy
    Brachytherapy, sometimes called internal radiation, is one type of radiation therapy that's used to treat cancer throughout the body.
    Brachytherapy allows doctors to deliver higher doses of radiation to more-specific areas of the body, compared with the conventional form of radiation therapy (external beam radiation) that projects radiation from a machine outside of your body.

    Chemotherapy
    Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. However, chemotherapy not only kills fast-growing cancer cells, but also kills or slows the growth of healthy cells that grow and divide quickly. Damage to healthy cells may cause side effects, such as mouth sores, nausea, and hair loss. That may sound frightening, but there are many ways you can help manage chemotherapy side effects; and they often get better or go away after you have finished chemotherapy.

    Hormone therapy
    Hormone therapy is a cancer treatment that slows or stops the growth of cancer that uses
    hormones to grow. Hormone therapy is also called hormonal therapy, hormone treatment, or endocrine therapy.

    Targeted therapy
    The most expensive treatment for cancer. Targeted therapy is the foundation of precision medicine. It is a type of cancer treatment that targets the changes in cancer
    cells that help them grow, divide, and spread.




    Thailand’s leading cancer centres in Thailand

    Public

    • National Cancer Institute of Thailand: The leading national institution for cancer control and patient care. Their mission is to develop and manufacture knowledge and technology for cancer and to create policy-oriented recommendations.
    • Siriraj Cancer Center: The center provides comprehensive cancer care and treatment by a multidisciplinary team of cancer specialists, including physicians specializing in cancer and chemotherapy, radiation oncologist, surgical pathologist, anesthesiologist and dietician.
    • Division of therapeutic Radiation and Oncology, King Chulalongkorn Memorial Hospital: This Thailand’s leading cancer center provides a world-class standard of care. In addition to our top-quality care, the Center also places a strong emphasis on doing research and training future specialists in radiation oncology – radiation oncologist, medical physicist and radiotherapist.
    • Ramathibodi Comprehensive Cancer Center, Mahidol University, Faculty of Medicine Ramathibodi Hospital: Cancer specialists here are dedicated to providing cancer patients the best possible treatment and quality of care. Multi-disciplinary teams see patients whose personalised treatment planning is required.


    Private

    • Wattanosoth Hospital: Bangkok Cancer Hospital: With 10 years’ experience as a private dedicated cancer care institution in Thailand, Wattanosoth Hospital provides quality service with regards to prevention, diagnosis, and treatment of cancer patients under the “Concept of Total Cancer Care”.
    • BNH Hospital: For Onco-Gynecology, BNH have established a partnership with Chulalongkorn and MD Anderson from the USA. MD Anderson is one of the most reputable cancer centres in the UK.
    • Bumrungrad Hospital: The renowned hospital is JCI-accredited and treats 1.1 million patients annually across a number of illnesses, including 520,000 international patients.
    • Bangpakok International 9 Hospital: The multi-disciplinary care hospital offers an extensive range of procedures with an internationally-trained medical team comprises of more than 150 physicians.
    • Oncology Center Phyathai2 Hospital: The hospital offers comprehensive medical services starting from diagnosis to effective cancer treatment provided by well-known medical teams and trained nurses. Also, modern tools and equipment along with MTD Team can give best results of treatment.


    Read our comparison on government and private hospital in Thailand here.

    Bottom Line
    Luma's health plans offer premium coverage for cancer treatment, to find out more
    download our brochure here.

    Last edited by bowie; 29-07-2019 at 10:40 AM. Reason: dress

  2. #2
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    I am now suffering from depression of the brain cells , very costly !

  3. #3
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    crackerjack101's Avatar
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    Thank you Bowie for the information, out of date as it may be.

    I have terminal cancer and am fortunate enough to be an Australian citizen.

    The Aussie system, Medicare, has looked after me in the best possible way since 2015 and I am, to this day, astounded at how good they've been.

    The fact that I live in Thailand 90% of the time has not been an issue, I simply return to Australia every 3 months for what ever treatment they deem neccessary.

    As far as Thailand is concerned my local village hospital, happily sells me whatever drugs I need with no questions asked.

    Their senior Docter , Doc. Pittipat, is a terrific bloke and has never been less than considerate and helpful.
    So much so, we have discussed my eventual demise, and his advice and suggestions have been most reassuring.

    The one thing he apologised for was his inability to help me die as and when the time comes.

    This is an issue in so many countries and really is an issue for someone with my problem.

    Phenobarbital, the medication of choice, is only available to some veterinary practitioners and, as far as I can ascertain, it's not readily available in Thailand or Laos.

    So, regardless of the magnificent facilities available in Thailand and around the world, when you get caught up in a nasty i.e. Multiple Myeloma, alternative action is required.

    Unfortuhately this is not readily available and no matter how much cash you blow on putting off the inevitable, we're all going to die.

    Thanks again for the info Bowie.

    I wish you well.

    pip pip

  4. #4
    I'm in Jail

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    Tuff break guys. Best of luck.

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    The Fool on the Hill bowie's Avatar
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    Quote Originally Posted by crackerjack101 View Post
    I wish you well.
    I reciprocate - fight the good fight. I have thought long and hard concerning my situation. I am reasonably cashed up. Carry a good expat insurance policy. None of that means squat if I get that final call. Discussed with wife. 63/58yo. My bucket list is complete. Her philosophy is "who cares" we are all gonna die, don't get me any insurance (she is a Thai citizen). Our insurance policy USD $1M per incident covers us both. So, today it is reasonably priced, as we age, it will "eventually" become cost-prohibitive in the sense that neither of us would choose to undergo chemo, or get an organ transplant - quality of life issues. As far as my countries USA's Medicare system - not worth the effort - I'll die in Thailand unless they kick me out.

    At some point in time we will need only accident and palliative care - I keep looking and will adjust when the time comes. When my time comes I expect a trip to the north of Thailand up to the hill tribes to get hold of enough of that poppy sap to ease my passing. Of course, that is easy to say as I'm not facing the situation. And I have no real idea of just how I will react if or when I really must face such a decision.

    Crackerjack, fight the good fight, prepare you loved ones, and do what you can to kick cancers ass. The only thing that Matters Is "Quality of Life".

    May your passing be painless, may you just forget to wake up one day.

    My prayers go out to you.

  6. #6
    Thailand Expat misskit's Avatar
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    Quote Originally Posted by bowie View Post
    When my time comes I expect a trip to the north of Thailand up to the hill tribes to get hold of enough of that poppy sap to ease my passing.
    This. It seems to be the only way.
    Last edited by misskit; 29-07-2019 at 06:33 PM.

  7. #7
    I'm in Jail

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    And may you stay forever young.






    Dylan

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    crackerjack101's Avatar
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    To what "Poppy Sap" do you refer?
    I live in the north, near Chaing Kong, and, unless you're referring to opium, which is highly unlikely to close your door, though it will and does make things quite pleasant, the objective, when the time comes, is a painless, as much as possible, and undramatic slipping off the old mortal coil.
    Opium/morphine and the like will be a pretty dodgy way of going about it as far as I know, having researched it for the last 3 years.
    I'm happy to be proven wrong. More than happy actually.
    Delerious.

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    The Fool on the Hill bowie's Avatar
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    Quote Originally Posted by crackerjack101 View Post
    having researched it for the last 3 years.
    Crackerjack, yes, that was what I was referring to. Your research will of course provide correct answers, not the disillusion I was under. Gotta rethink my what ifs. If/when the time comes hopefully my research will provide easier answers.

    Obviously a most complicated subject - answers only you yourself can provide.

    Euthanasia is becoming more "accepted" and by accepted I mean legal in more locations. I am certain your research has lead you to that. That being said, I will stop talking about issues I have little or no knowledge in. I wish you the very best and hope for your sake the future meets your needs.

    Quality of Life. May your remaining time be peaceful and stress free.

  10. #10
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    Quote Originally Posted by bowie View Post

    Euthanasia is becoming more "accepted" and by accepted I mean legal in more locations.
    Not really. Active euthanasia is legal in only 5 or so countries around the world. Assisted suicide is legal in half a dozen US states. Passive euthanasia is legal in some countries.

    Still a long way for us to go in both palliative care and end of life issues.

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    Quote Originally Posted by nidhogg View Post
    Not really. Active euthanasia is legal in only 5 or so countries around the world. Assisted suicide is legal in half a dozen US states. Passive euthanasia is legal in some countries.

    Still a long way for us to go in both palliative care and end of life issues.
    You may be right, but let's be real, it's down to us and fuck the legislation.

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    Thailand Expat misskit's Avatar
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    Euthanasia aside, remaining comfortable until the end of life is important. Morphine is used in hospice care here in the states for comfort, not to cause death. I guess if one wanted to, they could overdose on the morphine the same way someone could overdose on opium sap or oxycodone. No?

  13. #13
    The Fool on the Hill bowie's Avatar
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    Quote Originally Posted by crackerjack101 View Post
    Opium/morphine and the like
    crackerjack - I should have mentioned this before, but, in 1984 my father passed from lung cancer that had metastasized virtually everywhere - inoperable. Our family doctor provided him with a rather large bottle of liquid morphine. My distraught mother queried the Doctor as to dosage and was told "he is dying, he can have as much as he wants."

    Another friend of mine passed of colon cancer in a hospice with a morphine drip that basically keep him asleep for his final hours.

    Neither passed in pain. They both transitioned while asleep even though the sleep may be categorized as drug induced.

    Sorry if this sounds non-caring or harsh. It isn't. It's just a bit of information. From my understanding morphine is just a more concentrated form of opium.

    Take care of yourself and your loved ones. Peace be with you.

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    i watched both my mother in law (breast cancer) and brother in law (brain cancer) die in thai private hospitals in bangkok.

    the doctors were insistent in treating right up until the last minute, and in the case of my mother in law were offering her invasive treatment even though she was on deaths door. the family had a fight on to get the hospital to leave her in peace. similar with my brother in law. 2 days before she died, my mother in law was being taken down for physiotherapy, even though her eyes were closed and she could hardly move.

    the idea of sympathetic end of life care (i.e. peaceful surroundings and morphine to bring on the inevitable) goes against buddhist beliefs and death must be a natural occurrence with no aid from mere mortals. in fact nurses were in and out of the room many times a day taking blood and disturbing her.

    whilst undergoing treatment there was very little cooperation between departments, e.g. the surgeon ordered blood tests and a ct scan, then a week later the chemo doctor ordered blood tests and a ct scan, then the radiotherapy department ordered blood tests and a ct scan. the family need to keep a vigilant watch on treatment to make sure that drugs are taken as directed and not missed out, scans and tests etc. are not unnecessarily duplicated and they should keep a record of all doctors visits, medication, etc.etc.etc.

    bill padding, either by intent, or due to sloppy record keeping was a big big problem.

    the nursing was efficient but cold. there was little interaction between nurses and either patient or family. they came in and did what they had to and departed. no smiles, no empathy, no chat. most, but not all doctors were arrogant and did not take kindly to being asked questions about treatment options.


    if it was me, i would want to be in a uk hospice for my last few weeks.

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    The Fool on the Hill bowie's Avatar
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    Quote Originally Posted by taxexile View Post
    bill padding, either by intent, or due to sloppy record keeping "is" a big big problem.
    Been there - very sad thing, but, having "good/excellent" medical insurance is a double edged sword. The medico's in the USA are well practiced at billing for every penny you are worth. Got good insurance, well, your hospital stay may well be extended and many "extra" tests (not necessary) may well be prescribed. A sad situation.

    Realize that the medico's are highly trained professionals, But, they are naught but "consultants". In the USA folk are trained to treat the Doctor's as Gods - do what the Doctor says. Yet, Doctors are human beings and as such, do make mistakes. They are paid to "advise" you, it is your responsibility to yourself and your family to listen to them, but, to make your own decisions concerning your health and well-being. Get second opinions - keep your legal medical directives "up to date".

    Legally in the US and, a part and parcel of the medical hippocratic oath, they are charged with "keeping you alive" - whether in your best interests or not.

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    Quote Originally Posted by taxexile View Post

    the nursing was efficient but cold. there was little interaction between nurses and either patient or family. they came in and did what they had to and departed. no smiles, no empathy, no chat. most, but not all doctors were arrogant and did not take kindly to being asked questions about treatment options.

    .
    For balance, when I was hospitalized after a heart attack in a Thai Gov hospital, the nursing staff were excellent. Kind, concerned and attentive.

    To be fair, palliative, late stage cancer nursing has to be brutally hard. You know the patients are going to die fairly soon. Empathy would burn you out damn quick. Just a personal feeling.

    For the docs, yeah - in all countries most of them are arseholes.

  17. #17
    Days Work Done! Norton's Avatar
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    We had a member here dieing from terminal disease he was suffering from. On my last visit to see him he begged me to help end it. For various reasons I had to refuse to help. A very difficult decision and something I often think about.

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    The Fool on the Hill bowie's Avatar
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    Quote Originally Posted by misskit View Post
    I guess if one wanted to, they could overdose on the morphine the same way someone could overdose on opium sap or oxycodone. No?
    yes, correct - really you can overdose on just about anything - you can overdose on booze - in the US we don't call it an overdose, we call it "alcohol poisoning" had a brother pass away of that at the ripe old age of 52. Drank too much and basically, his body forgot to breath enough, three days later with no brain activity, we pulled the plug - and, by the way, pulling the plug does not result in instantaneous "death" I believe it was about 18 hours after pulling the plug that he was pronounced dead. A very sad vigil for the family.

    In the USA we have an epidemic of deaths from fentanyl - a cheap and most powerful synthetic that is being used to cut heroin. It has resulted in many, many accidental overdoses. Including a second brother of mine.

    Fentanyl Abuse: Top 11 Facts About This Potent and Deadly ...
    www.drugs.com/illicit/fentanyl.html
    2019 Report: CDC: Fentanyl Overdose Deaths Are Soaring Fentanyl is a legal prescription drug used for pain control during surgery and for chronic or breakthrough cancer pain. It's also being manufactured illegally and sold for its euphoric effects.

    Unfortunately, or fortunately depending upon your line of thought, fentanyl laced heroin is available in every major city in the USA.

  19. #19
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    I don't know having never looked into it or asked around, but would strongly think that the correct cocktail(s) of pills to take which would put someone into a sleep they'd never wake up from are all freely available over the counter at any local drug store.

    Don't ask for Aspirin though, you can't get Aspirin here any more

  20. #20
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    Might I suggest a bit of a google of the various Terry Pratchet videos on assisted dying and the right to die. Various myths are debunked and truths explained.
    Incidentally, prescription morphine, liquid, is more likely to put you to sleep for a few days, destroy your kidneys and possibly your liver and leave you even sicker and more of a burden than dead. Same applies to many such pharmaceuticals.

  21. #21
    The Fool on the Hill bowie's Avatar
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    [QUOTE=crackerjack101;3979869] various Terry Pratchet videos on assisted dying and the right to die.[/QUOTE

    Crackerjack - thanks for the referral, most helpful and educational.

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    Quote Originally Posted by crackerjack101 View Post
    Might I suggest a bit of a google of the various Terry Pratchet videos on assisted dying and the right to die. Various myths are debunked and truths explained.
    Incidentally, prescription morphine, liquid, is more likely to put you to sleep for a few days, destroy your kidneys and possibly your liver and leave you even sicker and more of a burden than dead. Same applies to many such pharmaceuticals.
    Same with paracetamol overdose. It will kill you - eventually - from liver failure.

    It is kind of ironic that killing people is so easy, and yet when you set out to end someones life in a humane, controlled manner it turns out to be surprisingly difficult

  23. #23
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    Quote Originally Posted by nidhogg View Post
    Same with paracetamol overdose. It will kill you - eventually - from liver failure.

    It is kind of ironic that killing people is so easy, and yet when you set out to end someones life in a humane, controlled manner it turns out to be surprisingly difficult
    Indeed. When ones objective is to shuffle off leaving as little pain for friends and relatives as possible one is just as likely to end up causing more complication, problems and anguish.

    It could be argued that off all things one realy really needs to get right in life is death.

  24. #24
    The Fool on the Hill bowie's Avatar
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    Quote Originally Posted by nidhogg View Post
    end someones life in a humane, controlled manner it turns out to be surprisingly difficult
    Don't know if it's "difficult" per se, It is "Illegal". And, it shouldn't be, but...

    Quote Originally Posted by crackerjack101 View Post
    it's down to us and fuck the legislation.
    100% Correct. It is up to us.

    Euthanasia - is a highly debatable subject, ethically, morally and religiously. However, set all arguments and rhetoric aside, until you are actually "in those shoes" your/mine/our opinions are non-consequential. Debate the issue 'til the day you die - won't matter. Dr. Kevorkian made great strides in the issue of legalization of euthanasia and was demonized and jailed for his activities in helping terminally afflicted sufferers.

    Now, again, as I am not in those shoes, my opinion and my stated expectations are of no value. If or when I am in those shoes my beliefs may change radically. That being said, at this point in time, I do believe that, should my "quality of life" decline to a "negative" point I would take steps to end my life in an easy, comfortable manner, after making peace with my God.

    Now, as stated before, my planning would be along the line of a drug induced stupor/sleep and an inert gas suffocation along the lines of the article posted below - and, funny but, my second chosen method would be the easy way out a swan dive (no preparation required).

    From a recent article (did take me a while to find it)
    https://www.farang-deaths.com

    Farang Deaths: Documenting deaths of foreigners in Thailand



    April 25, 2019 James Lewis Hamilton

    Police are investigating the death of an elderly American couple in Chiang Mai. The two foreigners were found dead in a hotel with plastic bags around their heads hooked up to balloons filled with helium in what police believe to be a well-thought-out double-suicide.

    Pol Lt Col Mana Sukjaroen, who leads the investigation, said he was notified of the incident at 12:20 on Thursday. The report came after a room maid at the
    Top North Hotelon Moon Muang Rd near Tha Phae Gate in Chiang Mai’s Phra Singh subdistrict discovered the bodies of James Lewis Hamilton, 75, and his 70-year-old wife Diane Adele De Simone.

    Investigators interviewed the manager of the hotel, Pricha Maijandaeng. According to him, Mr Hamilton and Mrs De Simone, who had been staying in the hotel since April 13, were due to check-out on the day their bodies were found.

    “Mr Pricha told us that he called the phone in room no. 3207 on the 2nd floor where the two were staying after they did not check-out at 12:00,” Pol Lt Col Mana said. “However, nobody picked up, so Mr Pricha asked a maid to go to their room.”



    After the maid’s knocks on the door also remained unanswered, she reportedly attempted to gain access to the room by using a spare key. As she opened the door, she found a piece of paper attached to a hanger reading “DO NOT ENTER – CALL POLICE”. She then found the lifeless bodies of Mr Hamilton and Mrs De Simone on the bed inside the room.

    An initial police report states that both foreigners had plastic bags wrapped around their heads which were connected by a thin hose to a balloon filled with gas from a tank in the room. The valve of the 40-litre-tank, which police say most likely contained helium, was fully opened and the content already empty, leading police to conclude that the couple had committed suicide and died of
    inert gas asphyxiation.

    Forensic police briefly examined the bodies on the scene and said they were in full
    rigor mortis and therefore have been dead for at least 12 hours. They were dressed wearing white t-shirts and grey shorts. Both of them wore diapers, the police report stated. A note with contact information was also found in the room.

    “All the preparations they have made make it look like a well-thought-out double-suicide,” Pol Lt Col Mana interpreted the scene. The maid said that the two guests were a jolly couple and gave no indication they were going to commit suicide. Three days before the incident, they had greeted her in a friendly manner and asked not to be disturbed, police revealed.

  25. #25
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    I have nothing but respect for the couple mentioned above. They made every effort to prevent as much "mess" as possible and went out of their way to reduce, as far as is possible, the stress and trauma of their discovery.
    Respect.
    I hope I can achieve something similar when the time comes.
    Whilst my preference would be medication rather than helium it's certainly worth considering.
    My primary concern and though is and always has been how to minimise the pain and anguish of my family. Open, careful conversation is crucial and the sooner the better. Time helps acceptance.
    Thanks for the article Bowie.

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