ayahuasca

This may be relevant to anyone seeking out a sleep study in Thailand:

Here are suggested improvements for the sleep study process at [most expensive hospital in Bangkok]

First, hygiene standards need improvement—currently, about 20% of hospital staff at the Hospital don't properly wash their hands before patient contact, potentially spreading pathogens.

Second, there should be a thorough intake process to document patients' sleep habits: their preferred sleeping position, whether they need or use elevation, what type of bed they use, and other relevant factors.

Third, mask fitting procedures need improvement, especially for elderly patients. Both nose masks and face masks should be tested, as elderly patients often have lower adaptation rates and may do better with face masks. ResMed offers different styles, including memory foam and silicone versions for example. ResMed’s memory foam masks are reportedly more comfortable, but we received a large silicone mask (alone with the C-PAP we ordered) before proper face measurement, resulting in an incorrect size, and waste of money. During the study, the patient was only tested with a nose mask with a chin strap.

After completing the study, we pursued CPAP treatment as recommended and was told we could order a CPAP from [most expensive hospital in Bangkok]. However, the medical records department took an unusually long time (6 days) to respond to simple questions from the insurance company.

The eventual CPAP delivery was problematic—the device was simply dropped off unconfigured. Configuration guidance and at least 2 follow-up sessions should be included in or at least offered as part of the CPAP purchase cost.

We requested the same equipment used during the sleep study—specifically the head strap and nose mask—not realizing a face mask would probably have been better for an extremely elderly person. We were told later that the study's particular head strap wasn't available in Thailand, and they provided an alternative which was of a different style. And, as mentioned, while both face and nose masks were included with the CPAP, the face mask was the wrong size. We later found out that one can download a guide from ResMed to figure out what size mask is appropriate.

To summarize the needed improvements:

1. Better sanitary conditions
2. Proper patient intake procedures
3. Availability of study equipment for purchase (for example the same type of chin strap)
4. Testing of both nose and face masks for elderly patients, and types.
5. Proper face measurements and mask sizing
6. Clear information about available mask styles
7. Proper CPAP configuration upon delivery based on sleep study results.

On 1/23/2025 at 5:36 PM, superal said:

My Alexa has been no problem for 5 years but now when I ask it to play a song , it plays for about 30 seconds then stops and says , " I am having trouble playing music from your library . 

I have re- installed it a couple of times but still the same . I also read on a search where others have had the same problem and no resolution . I called Amazon who said they would pass it to their technical section and get back to me  but not yet . 

 Anyone got knowledge on how to solve this ?

Apparently Amazon stopped allowing Amazon music in Thailand. See Reddit and other posts for a workaround. 

so apparently Amazon stopped Amazon music for Thailand. An easy workaround is to connect another streaming service to the Alexa app. 

to connect apple music 

see https://support.apple.com/en-gb/119922

note that there are 2 steps, first use the Skills & Games option to make the connection between Alexa and Apple Music, then using Setting and Music & Podcasts option to select Apple Music as default. Other music services, such as Spotify can also be connected in a similar fashion. 

It's been like this for a week for us, on all our Echo devices. Note the discussion on reddit. https://www.reddit.com/r/Bangkok/comments/1i47ocw/comment/m9ed2fi/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button

First thing to consider is the environment:

In countries without free speech, various forces suppress negative data that impacts reputation, and so on. 

I know first-hand and second-hand of hospitals in such countries giving legal threats for any negative information about them.
 

Second thing to consider is medical training:

The top medical schools in this particular country do not break above the 200 mark for ratings globally. Do you know that medical students in this country do not first get a proper 4 year college education but go right into medical school? 

If not, what else do you not know? 

You will see some western training listed on some MD’s résumés, but if you dive deeper, you will see that it was probably a 2 month short-course, and perhaps taken online. One site to check American board certification is here: https://www.certificationmatters.org/find-my-doctor/

Such a certification means they are actually keeping up on the latest research--there are similar certifications in Europe but less easy to research.  And 95% of all medical research is in English. So if your medical professional is not fluent in English, that’s a problem, esp. if your condition is serious. 

Compared to top hospitals in the "west", say the top 50 in Europe and the U.S., there truly is no comparison. If you actually do considerable medical research on your condition you will note this issue. (Other nearby countries to consider for advanced treatment are South Korea, and Taiwan, Singapore + Japan)

Yes, there are a few doctors here who are rather savvy, but that does not fix all the limitations you will find in private (and public healthcare). Aside from a deeply flawed structure, keep in mind that this country's GDP is less than that of Boston, MA, USA--i.e. limited resources. 

There are a lot of well-meaning, friendly expats in Thailand, however, a large majority of them have NOT had the advantage of a top notch education, nor experience with say, top 50 hospitals in the world. So watch whose advice you take. Again, beware of taking advice from people who really don’t know what they are talking about.

On 3/10/2023 at 5:27 PM, Sheryl said:

https://www.bangkokhospital.com/en/doctor/dr-potjana-jitawatanarat

 

https://www.bumrungrad.com/en/doctors/Tanawat-Jirakulaporn

 

https://www.bumrungrad.com/en/doctors/Harit-Suwanrusme

 

https://www.bumrungrad.com/en/doctors/Suthida-Suwanvecho

 

https://www.bangkokhospital.com/en/doctor/dr-bundarika-suwanawiboon

 

The first listed doctor's US training was the most recent (2014) and I find that is important.Lots of Thai doctors here  who trained abroad many decades ago, they tend to get un-acculturated after a while. Also may or may not keep up to date.

 

 

Only one of those MD's has kept their american board certification current--meaning they have proof of keeping up to date on current research and techniques. And I suggest that that is more import than when they last were in the U.S. for training or schooling. You can check board certification's online. Many of the thai docs (and other developing world docs) go for the brief trainings or seminar in the U.S. or Europe then add that to their credentials. Hopefully that's obvious to most of you. 

 

ok, regarding Zenni, I agree that they are good. I often use them to test new prescriptions. I however, get my daily lenses from shop/lab in los angeles, an I get Shamir Autograph III. If you are looking for higher end lenses, in my experience the shops in Thailand are a total rip-off. They are charging 3 times what it cost for me to get Shamir, Varilux or Zeiss in the U.S. And about 25% higher than the pricey shops in New York (for example pick a pricey shop in Soho or Chelsea). But.... but! maybe it's it's also that I walk in wearing Mykita or ic-berlin! and transitions and they see "white American guy speaking English" and up goes the price. Btw. a word about Zenni, sometimes they ship via Europe now, and then Thai customs has been adding import duty. When shipping via China or Hong Kong there was not duty. But please folks, any suggestions for Bangkok, for a friend of mine who needs some ASAP. 

would appreciate a recommendation an infectious disease specialist, pulmonologist, or et. al. to confirm why such tertiary antibiotic.

following up on this question of what antibiotic. 

the pathogen has not yet been identified, however tests done were

Influenza A+B NAAT test (negative) Covid-19 NEAR test (negative) Streptococcus Group A test (negative), and gram positive sputum culture (normal flora). doc started my father on levoflaxin. This is considered a tertiary antibiotic by NHS, NIH, and NCID (Singapore) with amoxicillin considered first course of treatment. After 4 days just stable, no real improvement, and of course more weakness from the levoflaxin. 

would appreciate a recommendation an infectious disease specialist, pulmonologist, or et. al. to confirm why such tertiary antibiotic. 

are planning a procalcitonin and respiratory viral panel (not sure why they did not do this in the ER 5 days ago) when we can get to the hospital as we cannot get home service(!) here (still trying)

thus we are stuck on koh samui. we do not interact with locals (have doing best practices for 3 years--no indoor restaurants, bars, etc.) live in caregivers also do not interact with others without distances and masking. (this yes is unlike 99.9 percent of thailand).  thus the microbial resistance may not been so important re location. 

thanks. 

re amoxicillin vs fluoroquinolones, note current guidelines from US NIH and UK NHS

https://www.nice.org.uk/guidance/ng138

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812437/

the answer appears to be here, however, your question is probably package and carrier specific (e.g. AIS, DTAC) 

https://www.ais.th/applewatch/inc_numbershare.html

The K1 visa process seems rather simple to do in terms of filling out the paperwork, and getting the various requirements. I would like to pay someone who has extensive experience to have a second look at the forms which need to be submitted. (It’s a 2 step process, first the benefactor – the American in this case–submits one form, then the beneficiary–the foreign spouse—gets an appointment as their (her) nearest embassy).

There are a bunch of agencies and attorneys which offer this service, but which have a very good idea of how things are playing out currently stateside (us) and in Thailand, in terms of both speeding up processing, and what slight changes or additions to the documents submitted may be recommended. E.g. are the delays so extensive should I say seek a letter from an elected official?--possible for me but not easy. Any suggestions on who (any location) to talk to / pay for to look at the forms and give advice? (Note: We have both been living together in Thailand for 3 years). Thanks. 

16 hours ago, ThailandRyan said:

The confusion is very evident.  Elsewhere in the world these numbers would be close to 2x's what it was 2 days ago, and so on. Today we should be seeing almost 12k cases if we extrapolate from 2 days ago.  Someone is either confused as to where to gather the numbers from as we can see by both the above sets of numbers, and then the possibility of a lack of testing this entire week. 

 

Maybe people have tested positive on the ATK tests and instead of retesting with a PCR test they have gone into self isolation or better yet since they are asymptomatic they do not give a flying f and need to continue to work as there is no life line for them as there is in the western countries.

yes, the numbers are all just part of the grand social engineering scheme. there's no proper testing nor modeling done in thailand. they should be doing mass testing of various areas, then sequencing (to learn more about how it is spread, and which variant subset, etc). they aren't and won't and so it's a guessing game on the part of all of us.

Yes, tried, and it was not successful. Using the same system as before (same OS, same browser). I also tried other browsers. The system that worked before was Microsoft Edge on MAC OS 10.13 (high sierra). Today I tried also on Firefox and Chrome (latest versions) Also I tried on the IOS app. So I will probably go tomorrow to the local immigration. (Yes, it remains a puzzle why they continually fail to produce a decent website or app, but if data is well-organized then graft can become more apparent). 

On 5/5/2021 at 3:34 PM, BumGun said:

The issue for me in this regard is it he inability to open a bank account unless I go down "less then scrupulous roots": ie an agent, which I have zero interest in.  Last time I tired on a tourist visa (3 years ago or so), I went to about 5 banks, I was told I "cannot open a bank account unless you get retirement visa" so I reply, "I cannot get a retirement visa unless I open a bank account to transfer money into" I I mean in terms of entry as a tourist and then conversion to non-o.  Getting one in my home country of Australia also seemed like a lot of bureaucracy, involving police checks etc etc

 

I assume all of that is a test to see how committed I am to getting said visa, obliviously I was never that comminuted to circumventing the burecracy

I did it the "legit" way but I don't think they want you to, given all the BS I had to go through. If you value you time at 1k baht per hour or higher, just pay an agent.

Online reporting issues should include 

• which operating system
• which browser 

That said, on OSX 10.13.6 (mac: High Sierra) using the latest google chrome browser (version 90.0.4430.93), it's very spotty. Using the latest version of Microsoft Edge (Version 90.0.818.42 ) it worked well. 

The other options (mail, agent, etc.) are also rather valid. Even if you are late, most agents can handle it, though there may be that 2k fee.

And yes, it is truly mind boggling how they cannot get it together to program a website efficiently. Perhaps it's nepotism, perhaps it's a reticence to have it all "on record." 

4 hours ago, sqwakvfr said:

I have thought about doing the exact same thing.  This is because I doubt I can get vaccinated in LOS until 2022?(at least I hope I do not have to wait that long).  I am willing to pay for the vaccine in LOS if private hospitals were to offer them(I would only take the Pfizer, Moderna, J&J or AstraZeneca).

 

i have looked into what it would cost  me to fly back to Los Angeles to get vaccinated and then return.

 

1.  BKK Covid Test                            $100

2. BKK to LAX roundtrip                  $1,000(I can connect in Manila for $650 but might not be a good idea).

3. LAX Rental Car for 21 Days        $1,000(I was shocked at this number but it looks the supply of cars is low for Hertz or Enterprise)

4. LA area hotel, motel or AirBnB  $1500(could be $2,000?)

5. LAX Covid Test before return     $150

6. 7 Day ASQ upon return to BKK   $700-1000

 

Initial total estimate                         $4450

*Not including food and/or wine

 

I already have  the required Health Insurance and the only other thing I would need is a COE from the LA 

Consulate

 

In the end I will wait in LOS and wait for my turn at getting "jabbed".   I just hope my turn comes in 2021? 

Sounds about right. Two caveats: the bloody quarantine upon return. Just today a local attorney (Samui) posted that they are now requiring a 2 week quarantine regardless. And, if you do the Pfizer or Moderna, you'd need to wait 2 weeks to return to be allowed the 7-day quarantine (if that's still possible). 

Also, yes the car rentals are now about double, even when using deals, and deal sites. 

Another plus of the US is that other vaccines available are generally superior/more current, e.g. their hepatitis, shingles, and HPV vacciness--e.g. Shrigrix vs Zostavax, Gardasil-9 vs Gardasil....

It's notable how the pandemic has "turned on the lights" with respect to public health systems globally. E.g. the propaganda about how great the thai health system is starting to fade.....except when compared to say cambodia ;-|

(yes skip manila, try JAL if you can BKK-NRT-LAX (or via HND), esp. for economy, and they are allowing multiple changes for free).

caucasian 1.8m, 81kg (6ft, 180lbs). I recommend the ergotrend ergo joy plus. for USD $250 I am/was satisfied, and I have used the aeron (herman miller), and steelcase, and a variety of others. nocnoc.com had them for THB7,500 but they are up to 8,500 or so. I understand that the top of the line Ikea chair is also good but their shipping to samui is 3,500(!). 

17 hours ago, chainarong said:

UK strain for starters, thats why the virus cases are  now up around 2 thousand, if they don't rip it into gear,  it shortly will be 5 thousand and so forth.

Yes, I saw that the powers that be had revealed at least the B 1.1.7. 

In the U.S., the Rockefeller Foundation recently launched a plan to develop a national genomic surveillance network for viruses. 

From their news release: 

When significant mutations occur, there is a need to understand their biology at the molecular level and determine how these changes in the virus impact its transmissibility, its virulence, or the effectiveness of vaccines and therapeutics against it.

Thus this seems fundamental: how can transmission be effectively stopped (and likewise businesses know what the future may hold) without specifically knowing what is at hand. 

Currently,  there are 5 major variants in the U.S., . What variants are in what was the most popular destination for Chinese tourists? 

As the SARS-CoV-2 virus spreads from person to person, the virus evolves, producing variants that may evade treatments and vaccines, and possibly re-infect people who have natural immune responses from prior infection. Identifying and understanding these genetic variants rapidly, along with sharing the information globally as quickly as possible, is vital to ending the Covid-19 pandemic. Most existing global genomic surveillance efforts are ad hoc, siloed, and inadequate to meet the demands of a rapidly changing virus.  - The Rockefeller Foundation

https://www.globalcitizen.org/en/content/rockefeller-foundation-action-plan-covid-variants/

(random ideas????

if you have symptoms, immediately get some insurance if you don't have it. some travel insurance will cover immediately even if you're already at your destination. 

if doing the RT-PCR test, perhaps you could send a friend to pick up the results? And also give out your friend's telephone number, but of course put your data down (they will do this for you with your ID when you get the test). if positive, perhaps you can enlist an attorney (or well-connected agent) to "enable" you to quarantine at home before they find you. 

it is not clear if Thailand has any of the advanced medications to treat Covid, and I presume they do not unless you have serious connections and cash. 

On 4/18/2021 at 8:12 AM, rabas said:

Did your private researcher estimate how many more cases there are? 2X, 3X, etc.?

 

I ask because a certain number of undetected cases exist everywhere. It is unavoidable.

 

You say this information is online. Do you have a link?

 

--Thanks.

she estimated 30x, occasionally figures emerge in the royalist press, the first I noted was this one https://www.bangkokpost.com/business/1900975/the-coming-storm but I will look for links to more recent ones. Without random mass testing studies (say 1000 from this area and demographic, and 1000 from that demographic) basic epidemiological work cannot be done. the forced hospitalization even if asymptomatic is also highly unusual (is any other county doing this?). About 1 million tourists from China every month up until Feb 2020, and then no locked down on flights until late March 2020....Anyways, more thorough (and anonymous reports) will probably occur in the near future. 

6 hours ago, Sheryl said:

The hospital makes no difference, it is the choice of doctor that matters.

 

Is this being done for routine screening or for a specific problem or symptom? Makes a difference as if the latter then best done by an appropriate specialist

A routine screening - however my last routine screening, 6 years ago, showed a couple polyps. And, agreed, the specialist is important, and the actual devices used play a role: as studies have shown there have often been oversights simply due to the standard colonoscopy devices. The latest tools include the  “Third-eye”, Full Spectrum, “Extra Wide Angle”, and the “G-eye” balloon colonoscopes. But I am not finding them in any of the Thai hospitals marketing materials. (This could of course be due to lousy websites that most of the hospitals have). 

If you consider yourself well-educated re: medical issues, could you recommend a hospital (and gastro if possble) for a colonscopy in Thailand? >>Thanks<<

(FYI I am not impressed with the CV’s of any of the gastro’s I have read at the various well-recommended hospitals in Thailand, and I am accustomed to going to the top 10-20—depending on the condition—teaching hospitals in the U.S.). 

But I am not pleased with the idea of doing the quarantine, et. al. upon return if I was to go the U.S. for this—even with the 7-day dance. Thus, I am strongly considering one of the usual suspects (Bum, BKK, Sam, etc). 

Thank you. 

[“well-educated” on health matters, could mean, for example, that you can name a few differences between viruses and bacteria or you know what “neuroplasticity” means….]

THERE'S NO TESTING....

get a clue people. 

No testing = no results = no Covid. ????‍♂️ (military gov't, FYI).