Sheryl

Frankly if you need a CT scan you should best be getting care off the island anyway.  One has to consider not just getting the scan but the skill/expertise of the specialist who would review it and treat you.

If the CT does not require contrast media you can get it done at an imaging center in Surat Thani for much less than at a  hospital - but make sure you first know the specifications for the scan. 

https://mrithailand.com/en/contact-us-2/

located inside Surat Thani government hospital which is  large regional level facility.

If you prefer private care, then depending in what your condition is, many people report  favorably on Taksin Hospital in ST. 

https://www.thaksinhospital.com/thaksin/index_english.php

7 hours ago, PoorSucker said:

Just a couple of days, no obvious infection source, she worry to much

No obvious source then if it persists should see a doctor.

2 hours ago, BilllyGOAT said:

Interesting that an antibacterial cream would be good for something like that. It doesn't look like an infection.
 

I've used antibacterial cream for skin issues in the past where it was a known bacteria infection, things like an abscess, but I would not expect that kind of cream to help for something like that. But if it works, great, and no point in questioning it. Just carry on until it's gone. Shouldn't be that long if it's working.  

There is a type of infection of hair follicles called folliculitis which looks similar to what he has, and of course the location fits.

8 hours ago, PoorSucker said:

Sorry Sheryl, I'm on my fourth month with shinglels, my GF has lymph nodes.

There's a spray with tiger balm that I can recommend vs the the pain

 

Only sangsom soda helps

Ok. So your GF has enlarged lymph nodes.

For how long?

And is there an obvious infection source? e.g. sore throat or wound? 

3 minutes ago, Nayet said:

 

Thanks again. If the patent's expired, that explains a lot. They told me at Siam Pharmacy there's a substitute coming out soon called Duloz (I believe) made by a local manufacturer, so hopefully that will be cheaper.

Yes, it should be. But may take time to come out. If you can find Cymbalta I'd suggest ordering a years worth just in case.  

6 hours ago, CallumWK said:

 

I think the main point if they are taxable depends on if you report the transfers to the revenue department, because otherwise there will be a very small chance that they know about the transfer.

 

There is no procedure for reporting transfers as such to the RD.

There is only self-reporting of assessable income on tax returns. 

4 hours ago, Nayet said:

 

Thank you, Sheryl.

Now that you're reminding me, I rember contacting Medtide at some point, so maybe I'll reach out to them again.

You wouldn't happen to know why Eli Lilly are taking it off the market in Thailand?

It would be a financial decision. Probably not enough sales volume.

Not just Thaiiland, they are taking it off market in many countries.

Patent has expired. 

14 hours ago, proton said:

 

Looka like bacterial as the Fucidin is getting rid of it after only 24 hours

Carry on then. And continue for a full week after it ckears. 

Eli Lilly has taken Cymbalta off market in many locations including Thailand.

However some places may still have stock remaining.

They have it at Medtide  https://medtide.com/product/duloxetine-cymbalta-30-mg-28-tablets-box/

(you may have to create an account to view it)

You should also check with  https://medisafepharma.com/

(Use the Messenger function to ask)

Since it is off market, resupply will eventually become impossible so, subject of course to expiration date consideratiopns, may be worth stocking up a bit

21 minutes ago, Jaymatheson said:

Hi again Sheryl.  Friend is post-menopause but is concerned that taking Oestrogel & Utrogestan will start her periods again .... as a doctor told her.  I don't think that's the case.  From what i've read she might experience some spotting etc. while her body adjusts but she won't experience extreme changes.  Correct?

It doesn't usually have this effect.

With the Oestrogel, should use the smallest amount that controls symptoms. This will usually be less than full applicator. That also helps to prevent much buildup of the endometrium. 

There are several different schedules that can be used:

Continuous (Oestrigel + utrogestan) every day, all the time

Oestrogel every day, adding Utrogestan for just last 10-14 days of the month

Oestrogel for 25 days of the month, adding Utrogestan for the last 10-15 days

Of these approaches the last one is most likely to produce some spotting but even that, in only some women.  The first is probably least likely to cause any bleeding but will also be more costly (the Utrogestan is not cheap!). 

So if she is troubled by spotting with one regimen can modify it.

All that said, no need to take systemic HRT at all unless she is significantly bothered by symptoms such as hot flashes and mood swings. 

Vaginal estrogen, on the other hand,   pretty much all women need. 

9 hours ago, Agusts said:

This crackling sound has been going on for about 1.5 month, when the ENT in the clinic cleared some wax the first time last week I had no sound for a good few hours, I thought it was sorted..., but came back. 

 

I think my next stop is with an ENT in Bangkok Hospital, I'm in Phuket. I called them before, 2000b for just a visit, plus 2500b more if any wax cleaning needed etc. ! 

 

But I need a second opinion and as there is no wax now I want him to check other possibilities..., I give it another week or two then will go... 

 

 

Suggest  https://www.phukethospital.com/doctor/perapun-jareoncharsri/

If he can't sort it out then see one of the Oral & Maxillofacial Surgery specialists in the Dental center there  https://www.phukethospital.com/center/dental-center/#doctors  or at one of the dental clinics.

2 hours ago, rgrdns said:

we wanted to try first other options which both doctors didn't mention until I spoke about e.g. laparoscopy etc....and actually both doctors didn't give us a safe good feeling in this even 10 min visit. 

C) May I ask why the determination to avoid hysterectomy? For fibroids it would be removal of only the uterus, a very simple procedure which can often be done laparoscopically or even sometimes vaginally with minimal or no abdominal incision. 

 

 Laparoscopy is still a hysterectomy, just a less invasive (but more costly/technically difficult) approach. While fibroids make it a bit harder, a skillful surgeon would usually be able to do laparoscopic hysterectomy with 2 medium sized fibroids in the uterus.  I say "usually" as they don't know until they try and it can sometimes happen that they have tyo switch to open approach after first trying laparoscopically.  Doctors  would not usually mention laparoscopy as an option separate from hysterectomy, since it is a hysterectomy. The issue of laparoscopic vs open approach comes into play only if the patient has decided on hysterectomy.

Re GYNs, depends on what you most want. I find this doctor at St Louis to be a very good communicator, unpretentious, frank  and  personable:

https://saintlouis.or.th/doctor/dr.petcharat--pitahongnun/8ec97b6a-7666-4fa5-8561-fbbaac15ba7b

However, as of last time I saw her (admittedly some years ago), she herself did not do laparoscopic surgery though has no issue referring to someone who does.

So if what you mainly want right now is explanation and discussion of options she would be a good first choice. At St Louis it is first come, first serve so I'd suggest a Wednesday or Thursday as apt to be less crowded which means more time possible with the doctor. 

Give it a  week or so  then if persists see a doctor.

Start with an ENT.  If no success then a dentist speciaizing in jaw problems. As this sort of thing can be from either ear issue or jaw/TMJ issue.  Where are you located? 

Might also try chewing gum and intentional yawning as these can help reset pressure in the Eudtachian tubes. 

P.S. while your post talks only sbout fibroids, title mentions also menopause.. please clarify.

If she also needs treatment for  menopausal symptoms (e.g. hot flashes, mood swings) then

(1) all the more reason to have hysteretomy if  fibroid related symotoms are intolerable,  as medical management of fibroids will often worsen menopausal symptoms. 

(2) unlike fibroids, which any GYN can handle, there is much more limited range of  doctors skilled in HRT so please specify.

22 hours ago, Lorry said:

These are all steroids. They will suppress the symptoms for a while,  and then it will come back. Avoid them. 

 

You can try what @NickyLouieand I recommend above. Our assumption is that it's fungus.  If antifungal therapy (without any steroids!) doesn't have any effect in a week or so, go see a doctor. 

Agree, reasonable way to proceed. 

If antifungal seems to work continue it for at least a  week past full disappearance of the rash. 

Please stop bickering.

Psoriasis is an autoimmune condition. 

SOME  sufferers find that certain foods trigger or worsen symptoms. Which foods exactly is highly individual and for some people diet has no effect at all. 

Of course I can recommend various doctors but I do not think it will  achieve your desired aim of avoiding surgery. 

With fibroids, no treatment is needed if the symptoms are tolerable. That is, obviously, a subjective assessment.  I do find though that Thai women tend to be unduly worried by menstrual irregularities and also to fear (incorrectly) that fibroids may turn cancerous.  If her problem is more this (fear/worry) than that the symptoms are physically  intolerable, simple reassurance may suffice,. 

If the symptoms are not  tolerable, then first line of treatment is hormone therapy. The hormones least likely to cause significant side effects (e.g. birth control medications) have already been tried in your case. Next approach would be either surgery or classes of drugs known as Gonadotropin-releasing hormone (GnRH) agonists and Gonadotropin-releasing hormone (GnRH) antagonists. These drugs have significant side effects including loss of bone mass which is especially undesirable in women nearing menopause age, and hot flashes. Unless there is a desire to have children, most doctors at this point would advise a simple hysterectomy instead for a woman her age. 

There is a drug called Ulipristal which some places here are using, but it has been linked to serious liver damage in some women and is thus not approved for use in Europe except in women with a medical contraindication to surgery and intolerable symptoms from fibroids. 

I am not clear what you mean by "everyday extra bleeding started more or less depending on the period cyclus". If you mean she is now having spotting (light bleeding) on most days, or between periods, this could also just be because she is nearing menopause, irregular periods are normal during that time.  Even iuf she were to revert back to DMPA injections, might still have soem menstrual irregularity for this reason .

In short, continuing to try non-surgical treatments at this point -- given that the safest/simplest ones have already been tried and failed -- may cause more (and more serious) problems than just having the hysterectomy, assuming she cannot simply tolerate the symptoms. The latter would be best if possible, as at age 52 the fibroids are likely to shrink  on their own soon as she enters menopause (though if she then needs to use HRT, that can sometimes cause the fibroids to not shrink or shrink more slowly). 

I don't think any Gyn is likrly to give different advice than this given her age and experience with hormone therapy to date.

May I ask why the determination to avoid hysterectomy? For fibroids it would be removal of only the uterus,  a very simple procedure which can often be done laparoscopically or even sometimes vaginally with minimal or no abdominal incision. 

On 6/30/2025 at 2:03 AM, K2938 said:

Is this still a strongly recommended place?  Just wondering as its reviews on Google are kind of mixed.  Thank  you!

 

 

I use it.

Of course, like anywhere, varies somewhat with the doctor. I have gone there for some 20 years, only one dentist there I did not care for, all the rest were fine. And they offer all specialties. 

you will find mixed reviews for everyplace, unless the place itself has somehow rigged the reviews. And people are always more likely to recount or post a negative experience than a positive or neutral one. 

Please give the names of the creams/lotions already tried.

13 hours ago, NoshowJones said:

Thanks for telling me that, but can you confirm that Hydroxyzine is 100% non addictive?

Hydroxyzine is not physically addictive. 

Neither is doxylamine, another available OTC sleep med in Thailand in the antihistamine family (brand name Sominar)

BUT both of these can cause grogginess next day and this class of drug (first generation antihistamine) is not recommended for regular, sustained use (e.g. every night) especially in the elderly. In the elderly, may cause or worsen confusion and  cognitive decline especially if taken regulalry. Though as with all side effects, individual response may vary.