Sheryl

Vitamin D will do nothing. You did ot answer my question about menopause and this makes all the difference as the point of hormone therapy (even if it works) would be to temporarily control symptoms until menopause, after which the fibroids will hopefully shrink naturally. If on the other hand she has already passed through menopause and still has fibroids large enough to cause significant pain (if in fact this is the cause of the pain and not something else) then that is pretty much a non-starter. Sop please find out about this. ALso does ultrasound report give the size of the fibroids? Hormone therapy can be done with oral or injectable contraceptives or -- if these do not work -- with a class of drugs called GnRH agonists, the former is quite cheap, latter is expensive. All of these have potential risks/side effects especially in an older woman and this is a temporary not permanent solution. Hysterectomy at a private hospital will cost around 250-350 k whereas it would be free free going through the government system (which would probably mean getting a referral from her community hospital to either provincial hospital in Nong Khai or the regional hospital in Udon). If I were you I would think very carefully about paying for her to have surgery privately. Not only is it wasting a significant amount of money, for something in no way life threatening, but it will set up expectations that could easily bankrupt you in future.

Preparation: Laxative solution to clean out your bowels. Some hospitals have you do this at home, some have you come in several hours in advance and do it there. You may also be given special dietary instructions for the day prior. Varies with the hospital & doctor, but low fiber for a few days and clear liquids only the day before are typical. During: little to no experience as you are usually put to sleep with IV sedation After: nothing special; though some people find they pass a lot of gas in the initial hours. Due to tyhe sedation, shpould not plan on driving home yourself as may still be a bit groggy/spaced out. Prices: depend on hospital (private vs government) and whether any polyps found, polyp removal and biopsy is additional to basic colonoscopy price. Nowadays, private hospitals in Bangkok are around 25-30k (not including any polyp removal and biopsy). There are periodic special packages with somewhat lower costs. Government hospitals usually under 10k. Recommended sources for the latter would be Chulalongkhorn going through their after hours clinic, or Chulabhorn Hospital. https://kcmh.chulalongkornhospital.go.th/en/clinic/after-hours-clinics-and-premium-care-clinics-during-normal-operating-hours/ https://chulabhornhospital.cra.ac.th/ Is this for a routine screening, or a specific problem? As if the latter, choice of doctor (doctor, not hospital) is very important. Please indicate if so and I will recommend doctor.

I did not say that I thought fibroids were not the source of the pain. I said they might ir might not be. Fibroids are a common finding even in asymptomatic women. But in some cases they do cause pain. Fibroids are not cysts and she definitely does not gave cysts in her uterus. So pretty sure it is fibroids (which are benign tumors). IF these are the source of the pain, treatment options are basically hysterectomy vs hormones. Hysterectomy is more definitive but in some cases hormone treayment may be tried instead e.g. if the woman is nearing menopause age but not yet in menopause. Has she slready reached menopause (No longer menstruating)?

Cysts in the uterus are almost nonexistant. Can't be what the ultrasound showed. Are you sure it is not fibroids in the uterus? Or cysts on the ovaries? (Though it would be unusual to have 4 of the latter). In any event -- and assuming these are the cause of the pain (might or might not be -- fibroids are common and often asymptomatic, so the pain could be due to something else) then the best place to go would be Udon Hospital -- the main government hospital there which is a regional level facility, a far cry from your local government hospital. If your sister in law lives in Phong Phisai District, that hospital is the lowest level, just a small community hospital with very limited capacities which may be why people tend to avoid it. A Regional level hospital is altogether different and has much higher and more speclaized capacities. If she absolutely refuses, then that leaves either Aek Udon or Udon Bangkok Hospital. Could get quite costly especially if hormonal treatment or surgery is needed. Try to bring records from the private hospital visit with you, especially the ultrasound.

Are you saying she has never seen a doctor about this at all? If so then no reason to assume it is a Gyn problem. Why do you/she think it is? And how can there be a "second opinion" without first having seen a doctor and gotten an initial diagnosis? "Abdominal pain" in a 50 year old woman can be many different things. And how did she decide on medications if she has not seen a doctor at all? And again, what were these medications? (There are no medications specific to "inflammation of the uterus"). What exactly ard her symptoms and how long has this been going on for? There seems to be a lot of missing information here. Please try to fill in the blanks so I can better advise you. Thais do not have to pay for medications at their registered gvt hospital. Yes they can be crowded....and if the hoepital where she is registered under the universal scheme is just a community hospital they may have to refer her on to a higher level hospital which means even more time initially but would be well worth it in the end. . The main govt hospital in Udon Thani is a regional level facility and arguably the best hospital in that part of Thailand. Consultations at private hosputals run 600 - 2000 baht depending on the doctor. Tests would be additional -- labs, likely ultrasound -- and would probably run several thousand more at least. Possibly 10,000 - 30,000 + if CT scan or endoscopy needed. Medications at private hospitals cost 4-5 times what they do at a pharmacy so best not to get meds at hospital.. Small upcountry private hospitals can be quite dodgy and are best avoided. If you are determined to take private route, best choive would be Udon, not Nong Khai. Udon Aek hospital for example. The "after hours" clinic In the main govt hospital in Udon town is also an option and perhaps the best one...but you need to know what doctor to ask gor (ditto a private hospital) and I can't advise on that without more info. Consultation there will be probably around 250 - 300 baht. Please try to provide the missing information and I can then give much clearer and more specific advice.

It is not legal to receive meds by mail unless you have an FDA license to do so (which you cannot get). It used to be the case that small parcels were let through but now that duty is being applied even to small value imports, customs pays more attention and there have been increasing reports of parcels with meds being intercepted and seized. You can try, but there is a definite risk you will nto be able to freceive it-- and oyu may have ot go to a custioms office and spend a a lto of time to reach that ending. There is a locally made generic in 5 mg dose called Casey 5, made by MacroPharm. I None of the Indian brands are ;licensed here but some pharmacies import them nonetheless. try Medisafe. https://medisafepharma.com/quote/ https://www.facebook.com/Medisafe.Pharmacy.Rama4/ (on the Facebook link, use the Messenger function).

There is no reason for you to pay for anything, she can get treatment for free in the government system as a Thai citizen. What government hospital is she registered at? At what hospital (if any) was she examined and these drugs prescribed/advised? What tests have been performed so far? And what were the drugs in question? (i would put little to no stock in what the person at the pharmacy -- who may not necessarily have been a trained pharmacist -- told you).

People who have had Hep C are ineligible to donate blood in Thailand (and most other countries as well). The two most common hepatitis viruses affecting adults and children over the age of 11 are Hepatitis B and C. If you contract either of these after turning 11, you are not eligible to donate blood. https://thaibloodcentre.redcross.or.th/en/donor-eligibility/

Completely untrue. You are eligible for Medicare even while still living overseas. You cannot use it in an overseas facility, but you can live overseas and enroll in Medicare, and also use Medicare during visits to the US. As I do every single year. Possibly you are thinking of a different country? For example there are some rules about NHS eligibility for Brits living abroad.

off topic political posts removed.

Some Advantage policies cover emergency treatment abroad. BUT this assumes it is a temporary visit abroad. You normally need to be permanently living not just in US but in the specific plan area. Usually at least 6 months out of 12. If actually living abroad and this comes out, it will invalidate the policy. They could even come after you for prior pay outs. So this is usually a viable alternative only for part timers. Possible there are some special emplyment related group policies which differ.

Thanks for the update. Goes to show how essential choice of doctor is. I have total confidence in Prof. Wicharn. World class expert with many decades of experience specifically in spine

I got Part B. I go back to the US annually for fam了ily reasons anyhow. Get all my routine preventive care then under Medicare. Most of it is covered under Part A with no copay but there are exceptions: Screening colonoscopy is free BUT if a polyp is found the entire thing gets reclassigied as a polypectomy and is subject to copay. Certain preventive services aren't covered under Part A e.g breast ultrasound, manual prostate exam, skin cancer screening. Allof these would come under Part B. I've used Part B for the things listed above. I also recently used it for treatment of a thyroid mass as my internationsl policy has a thyroid exclusion.

no. Travan = lorazepam, a benzo and thus a controlled substance.

Yes. Made by Unison. Brand name Dapfiga.

Sale and purchase of benzos OTC is illegal in Thsiland. They are controlled substances. With reason as highly addictive.

From what you describe no reason yo consider artificisk disc even if surgery is necessary . IF surgery is necessary then depending on specifics of your problem options would be fusion or possibly less extensive decompression. Both can be performed with minimally invasive/endoscopic approach.

Frankly there are only a handful of spine specialists here who know with real expertise. Pkease consult Prof. Wicharn as previously advised. Bring DVD of the MRI with you. Artificial disk implant is a (costly) alternative to fusion. Only real advantage is that it preservlves more flexibility.. ..but this is mainly an issue if fusion would be multi level. And even then depends on lifestyle/age/activity level.

They probably do.Will always cost more than open. About 15-20k more at a government hospital, 50K+ more at a private one.

Rolled up

https://www.bch.in.th/find-doctor/362 Bring your most recent lab redults with you

it does take some time after extraction before dentures can be fitted. A month at least. It is a bit concerning that the dentist already took mold and made the dentures, in my experience would do that only after full healing. I.e. first extraction, them a month or two later, once healed, make the mold for the dentures then return for the fitting. In Jomtien itself: Dr. Preecha Paijitrochana, DDS Smile Time Dental Clinic Jomtien 082-207-9691 Has been recommended by other AN members. Dentists that have been recommended in Pattaya include (in no special order) https://www.travel-dental.com/en/welcome-to-the-deutsche-dental-clinic-in-pattaya-thailand/ https://www.germandental.com/ https://www.dentalsmilepattaya.com/ Dr. Oyo SmileTimeDC.com - Fine Dentistry with a Gentle TouchSmileTime Dental Clinic, Jomtien, ThailandWe are a highly experienced Dental Clinic, Jomtien, Thailand, that prides ourselves in "Fine Dentistry with a Gentle Touch"

Sorry that link is old. This is the current one https://bch.in.th/find-doctor/72 He is there only on Tuesdays, arrive early. He is also at Bumrungrad on Thursdays but costs more there.

The only advice I can give is, if the constipation persists despite all this, that you get DVDs of the CT and the colonoscopy & gasttoscopy and take it to this doctor in Bangkok who is the country's foremost colon specialist: https://www.bch.in.th/find-doctor/doctor-profile/?smid=4581 Worth getting a second expert opinion on that scan etc

That us general health indurance. He asked about personsl accident insurance.