Sheryl

The brand of this (Sirolimus) available in Thailand is Rapamune.

Immunosuppressants are controlled in Thailand and have to be gotten fro ma hospital or clinic. You can try a doctor of the relevant specialty (e.g. oncology or neurology as the case may be) in Pattaya but I won't be surprised if none of the hospitals in Pattaya have it. Might need to come to Bangkok.

First of all, asking a nurse or anyone other than the appropriate doctor is a waste of time, as cost will very much depend upon the technique to be used and that can only be decided on after examination by the doctor.  (n other words, you may have been quoted a price for a procedure other than what you would actually need.

That said, upcountry private hospitals (not including Chiang Mai) are best avoided and not infrequently come up with costs way in excess of top tier Bangkok hospitals.

Where in Thailand are you located?

23 hours ago, In Full Agreement said:

 

 

I've been to two pharmacies to try to buy this product.    Both told me I'd have to go to a hospital to get it.

 

 

 

"Go to hospital" is typical response from (untrained) people behind a pharmacy counter when confronted with anything unfamiliar.

What you pictured is simply hydrocortisone cream 1%.

You were likely not dealing with an actual pharmacist. That, or they thought you wanted specifically this foreign brand.

The specific brand you have is not available here, but there are several brands of hydrocortisone cream that are:

• Hytisone
• H-Cort
• HC 1%
• Efficort

Suggest you write down on a piece of papaer "Hydrocortisone cream" and then these brand names beneath it

Where in Thailand are you?

6 hours ago, BigStar said:

 

Yes, the Special Clinic is a very good thing. I think you have to be referred from a doc in the hsp, but I'm not sure. Opens at 6 PM, but queue up at 5.

 

I very much doubt it requires a referral. Doesn't in any government hospital that I know of, the whole point of these "Special Clinics" is to let those who willing and able to  do so, to see a more senior doctor, of their choosing, outside normal government working hours.  Also serves to provide additional financial incentive/income for the doctors.

Not to be confused with seeing a specialist doctor within the public channel, which may indeed require a referral .

Stem cell treatment for arthritis is still in experimental stages.

Any clinic offering it, is doing so contrary to Thai Medical Council guidelines.

There have been some very bad consequences (e.g. tumor growth) from unregulated stem cell treatments in Thailand.

PRP is also still considered investigational but is less risky IMO (other than possible loss of money if it doesn't work).

@rumak I would suggest getting HA injection. If no improvement thenmight later consider PRP.  Leave stem cells aside until there has been more research. It is not just a matter of determining if it works, but also how best to do it.

1 hour ago, topt said:

Thanks Sheryl for the continuing updates. I am beginning to regret staying with them now.

I did not even consider that they would bump Thailand up a Zone.......

Neither did I. As I said before, I think due to the COVID experience.  Which was unusually (and unnecessarily) expensive for April due to a misguided government policy.

I may eventually get some benefit from the Zone bump as I now visit UK annually. But for most, it is going to just be a higher cost with no plus side.

10 hours ago, mania said:

 

Thank you Sheryl for your updated info much appreciated.

This is tough to take as my wife & I have been considering moving back to Thailand as we left in 2017

I am 67 & 68 this year. I know better than to be uninsured even though I am in good health/shape

 

But yes seeing these prices does make us pause. I of course prefer International policy given the track record of Thai insurers. Now seeing your prices I have given them a second look on https://checkdi.com/th/health/main?lg=en  

 

I wonder about AXA, Pacific Cross & LMG policies.  But again bad track records for Thai insurers when push comes to shove 🙄

I would advise against a Thai insurer.  The best of the bunch would be Aetna and AXA. I am not sure these will newly enroll people over 65 though. Aetna Thailand's predecessor guaranteed lifetime renewal only for those who enrolled before age 60. Be careful.

Also, at older ages premiums of Thai insurers are no less than -- and often more than - those of international insurers. 

Suggest you work with an jntetnational broker. 

2 hours ago, david_je said:

Yes, pls do post any update re hospital network.

On raising deductible, I also have Essential hospital only, $500 deductible, and premium for renewal this month is $4157. April quotes me $3907 if $1000 deductible. Hard to decide. What would you do? Thanks.

I haven't decided for myself yet re deductible. But if a doubling of deductible from 500 to 1000 saves only $250 then you'd have to average one claim every  two years to break even and 1 in 3 to come out ahead.  Personally given my age and recent claims history not such a  good bet.  Keep in mind that while you can always opt to increase a deductible, insurer is not obligated to let you decrease it, so should take a long view, considering health and finances not just now but further down the road.

Regarding this network business, broker replied that April does not really have networks the way some insurers do and that this "is just communication".  By which I think he meant miscommunication.  He also said that if the insurer were to reject a charge on ground of being too high  by local standards, they must supply legal proof and "offer policyholders an alternative".  I can't see how alternatives would apply in case of services already rendered i.e. outpatient visit or a day surgery not needing pre-approval. But clearly for inpatient hospulitalization it gets thrashed out in the pre-authorization  process. 

I am still awaiting quote for a switch to Basic and clarification of what happens in terms of room rate if the hospital has no twin rooms. 

Interestingly broker mentioned that April will have to increase premiums by 50% within 2 years to cover the change to Zone 2. In which case I would expect another 13% rise (not counting any infationary effect) next year. 

32 minutes ago, jas007 said:

I’m in Bangkok and went to Bumrungrad. I’ve been there before to the eye clinic.

I recommend you go to Rutnin Eye Hospital

15 minutes ago, AlaskaDave said:

That is very interesting information. I've been struggling with finding a way to avoid keeping 400K baht in my Thai bank. If I pass away, my Thai wife will need access to that money (I've willed it to her) but that access will take time and a lot of hassle for her.  If would like to just give it to her now and use another means of satisfying Thai Immigration's financial requirements.

I've used Wise for years and was thinking about doing a Wise Transfer to Bangkok Bank every month but my Visa advisor told me Chiang Mai Immigration wouldn't accept Wise transfers as such proof. Doing monthly wire transfers from a U.S. bank to Thailand is possible but expensive and much more difficult than using Wise because I cannot receive the OTPs my U.S. bank will send to my stateside phone.

Anyway, Jonathan Swift, those details aren't important for this conversation - which Immigration office are you using? Do you have any info that suggests I could use the Bangkok Bank's app to do international wire transfers?

Many thanks for your help.

Are your transfers by any chance from US Social Security? Because if so, SS will now do direct deposit to Thai bank. I get mine the 1st or 2nd of each month into my Kasikorn account without fail, and an added advantage is that one can get a "credit advice" for each transfer that clearly shows it is SS, in case of ever being questioned by Revenue Dept. (With Kasikorn can set it up to receive the Credit Advice by email automatically, I don't know re other banks).

Otherwise - For extension based on marriage, AFAIK there is no restriction on spending the money/keeping it in the bank (unlike extension for retirement, where there is.)

@DrJack54 Could he  could transfer the funds to a joint account after each extension then transfer back to the "visa" account  2 months before next extension?still some risk during those 2 months and the "under consideration" period but odds in favor of them being in the joint account when he dies.

?

38 minutes ago, tilac01 said:

It might help if you ask Geo Blue to send you a copy of the Guarantee of Benefits for your appointment via email, they're usually ok with that and send a copy in minutes.

As above. It may have been sent to the hospital but not to the right section/office.

Who at the hospital did you ask about this? Should be the 3rd party payment office. Not the cashier window. Cashiers are somettmes lazy about chasing these things down.

1 hour ago, jas007 said:

 Thanks. I went to the hospital today.  The bottom line: they said the IOL is dislocated and “has to come out.” I go back Monday for another appointment, and then see another doctor a week or so after that.  So I guess they’ll take care of the problem soon.  I didn’t know what to think.

What hospital did you go to? Where in Thailand are you?

2 minutes ago, david_je said:

On your premium notice, does it state Zone of Cover 2? Mine, due this month, still says 3.

Or do you have other documentation from April that your renewal is indeed for 2?

 

Yes, it says Zone 2 on the premium notice and also in the 2024 General Conditions, Thailand now shows as Zone 2.

As an aside, my broker mentioned that the insurer has incurred significant losses on policies in Thailand and I suspect this is related to the fact that during COVID, April was one of the few insurers to fully cover all COVID hospitalizations even those that were not medically necessary (e.g. asymptomatic or just mild symptoms). At the start of the pandemic Thailand had policy of mandatory hospitalization for anyone testing positive even if completely asymptomatic, and these hospitalizations were in "special" single isolation rooms that were very costly, and never for less than 10 days as they would nto even re-test until then.

27 minutes ago, tgw said:

 

30 baht a pill is a prohibition / smuggler price though.

If you read the earlier posts in this thread it was always extremely expensive. E.g. 5000 baht to fill a script.

20 minutes ago, BobBKK said:

 But why not do an autopsy here, cremate, and send it home?  I see no reason to ask people for money to send a cadaver to another country - still, it is their freedom of choice to donate or not, but it seems a waste of money. 

There are many reasons why a family might opt to send the body home:

- emotional

• completely unexpected death in a comparatively young person, people wish to see him one more time, and that might include older relatives not fit to travel to Thailand, or such a large umber of people that no cheaper for them to fly to Thailand than to bring the body back.
• need for closure: need to feel know the actual cause of death in as much detail/certainty as possible. Believe me, what one gets from an autopsy in Thailand does not do that (or much of anything else).  I have reviewed several "autopsy" reports of foreigners who died in Thailand, they are in no way of international standard and do not really give any insight into cause of death.

- religious beliefs/customs

-legal/financial: may need a UK coroner report to claim insurance etc. I doubt one could get a UK coroner verdict based on a Thai death certificate or "autopsy" report. At best it would be left as an "open verdict" and cause of death unknown. This can be a real problem if, for example, there was life insurance.

11 hours ago, RobU said:

'And moments later'

The operative phrase

There was no warning no time to put on seatbelts

Interviews I have seen with passengers variously stated no seat belt sign and that seatbelt light came on. All seem to agree no announcement (not surprising given how unexpected and serious the event was, pilot would have been busy coping with it and sending out distress call/request for emergency landing first).

I suspect that what may be the case was that light come on but virtually simultaneous to the event at which point no one had time to react...in fact those not already seat-belted were already being catapulted about.  May have come on automatically, I think that is programmed to happen? But in that case would have been only as the plane started its extreme movements.

8 hours ago, superal said:

I have seen recommended by doctors , to avoid DVT on long haul flights . 1/ Take a baby aspirin to thin your blood , prior to the flight . ( Sheryl's opinion / endorsement is welcomed )  

2/ Exercises for your legs can be done when seated and belted . Yes , walking around for 1 minute every hour was also stated but will put you at risk from turbulence events . Even normal ( scary ) turbulence can cause you to fall through loss of balance .

Yes, aspirin will help for this IF you have no contraindications (bleeding disorder, gastritis, history of stomach ulcers).

59 minutes ago, greg71 said:

https://www.smh.com.au/world/asia/bangkok-officials-block-australian-patient-from-voicing-singapore-airlines-criticism-20240523-p5jg4n.html

 

Despicable but worth noting, for those who may not bother to read the article, that this was done by hospital personnel apparently on orders of hospital administration. No indication that Singapore Airlines is in any way involved.

1 hour ago, KhunBENQ said:

For some reason the topic came to my mind yesterday.

I did some search for Shingrix ind Khon Kaen.

Found Ratchaphruek Hospital for 6300/shot. Guess there will be additional fees.

Khon Kaen RAM offers a single shot for 5000 (SKYZoster?) which seems less recommended.

For Bangkok Hospital here I can not find any clear statement.

 

Is there any chance that a public district hospital orders the vaccine on demand(deposit)?

Extremely unlikely since it is not part of the Thai immunization program. I don't think it will be any time soon given the cost implications.

SKY Zoster is not the same as Shingrix and not as effective as it. It is basically analagous to Zostavax.

There is no question that it is a costly vaccine, but having had shingles I can assure you, it is well worth it.

1 hour ago, tgw said:

 

Dr. Anywhere seems to be a local company:

https://www.doctoranywhere.co.th

 

Interesting indeed. First I have heard of them. Will be especially interested to see if they can obtain other drugs no off market, or otherwise hard to source,  here.

1 hour ago, bear9 said:

Hi

 

1.  I have no fever or any other symptoms 

 

2. No cuts or sores anywhere 

 

3. No bump on other arm or anywhere else

 

4.  Soft when you move it and freely moveable.

 

Also to note I showed it to a pharmacist in Bangkok a few days ago. The pharmacist said these words to me.

 

sebaceous glands under the armpit. Inflammation possibly coming from an infected hair follicule in the armpit. Pharmacist said it was not coming from the lymph node.

 

Pharmacist gave me some Fucicort cream to use twice daily but has been about 3 days now and feels much the same

Thanks

 

 

 

 

Sorry I forgot to confirm you are male, not female. Assuming you are, skip to next paragraph. But if by chance you are female, have you had a recent mammogram?

"sebaceous glands under the armpit. Inflammation possibly coming from an infected hair follicule in the armpit." is exactly what I was thinking of when I suggested hot compresses and gentle squeezing. I have had this a couple of times over the years , it is very common and one can usually squeeze out the sebum/oil etc which clears the matter and is all a doctor would be likely to do. I suggest you try this. Fugicort and other topical antibiotic creams are not likely to do a thing. If this is what it is, the pore is blocked and needs to be unblocked.

If a few days of hot compresses and squeezing does nothing, then I suggest you see this doctor, an American GP licensed in Thailand. He will refer you on if he thinks it needs specialist care. But -- assuming you are male -- my bet is one a blocked sebaceous gland and frankly it is  waste of time to see a doctor for that.

https://mission-hospital.org/en/our-doctors/40-clinics-centers/internal-medicine-clinic/959-dr-nick-walters.html

2 hours ago, Satcommlee said:

I'm adding to this topic because it comes up in Google search, I hope the information is useful to others...

Dr Anywhere (telemedicine app) can provide Zolpidem at 30 baht per tablet, you must first consult with one of their  Psychiatrists which costs 1500 Baht (quite expensive but you can't beat it for convenience) all done from your phone/tablet and the medicine will be provided by courier service.

In my case, I uploaded referral letter and medical notes confirming long-term use of Zolpidem.....  It is possible (and quite rightly) they may not be happy to prescribe this drug without first trying alternative options... 

Was this then shipped to you in Thailand? (Technically illegal).  By what means?