Sheryl

The MoPH sanctions it, yes. But government hospitals have considerable autonomy in how they implement this and many - indeed, most if one counts all the community level hospitals nationwide - do not have different pricing tiers as it is simply not worth the administrative hassle for hospitals that very seldom ever treat a non-Thai. In practice only hospitals in locations which regularly see foreigners bother to do this. And when they do it is usually just 2 tiers, Thai and foreign. I don''t know of any government hosputal applying the multiple tiers. Many, many things in that directive are not applied in practice.. Including the specific charge rates.

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It is NOT recommended -- by any public health or medical authority -- to remove healthy ovaries in premenopausal women undergoing hysterectomy unless the woman has specific risk factors for ovaraian cancer. The disadvantages of a "surgical menopause" far outweigh the advantage of preventing ovarian cancer in the small percentage of women who go on to develop it (about 2% overall, highest incidence being well after menopause). In women past menopause, it is more of a toss up decision and there is a lack of consensus. Some doctors believe it is best to remove in that case while others recommend keeping the ovaries in if no special risk factors, since even after menopause they continue to produce small amounts if hormones which, among other things, help protect against osteoporosis. Cancer can occur in virtually any organ of the body, this does not warrant the removal of healthy organs.

Note that most "cancer screening" in check up packages consists of unreliable tests recommended by no public health authority and apt to yield false positives (leading to unnecessary further tests) and negatives. There are no accurate screening tests for most cancer. The only cancer screening recommended would be: complete blood count (which she would get anyway), thin prep (formerly known as pap smear) mammogram, and perhaps colonoscopy. If she has a history if smoking, then low dose CT of the lung. Do NOT get the various blood tests many hospital tout as "cancer markers". These are used to track progression of cancer in some people who have it but are not suitable for screening. Not sure what you mean by "hormone levels". TSH (thyroid) makes sense at her age but hormone testing for menopause is complex and not very accurate/useful. Beware of the more "comprehensive" packages as these contain the unnecessary things mentioned above. Private hospitals design their check up packages for marketing purposes and they are not evidence based. What makes sense at your wife's age are: Complete Blood Count (CBC) Hb1Ac Lipid panel: HDL, LDL, triglycerides BUN Creatnine Liver enzymes (ALT, AST) TSH Thin Prep if she has not had one in last few years Mammogram EKG Chest Xray (if none in past few years) urinalysis stool for occult blood You will not find a package like the above anywhere that I know of . Best option is usually to take a lower level packaged as for younger people and then add on what is missing. + Maybe colonoscopy but that would have to be arranged separately.

Government Hospitals: in areas with few foreign patients, usually same price for all..not worth their while to set up separate price schedule for foreigners. (Of course, many Thais don't have to pay at all as they are covered under national scheme. ). In government hospitals with many foreign patients coming in, most have ways of charging them more. Might be an overall "surcharge" (e.g. 20% at Siriraj in Bkk) , might be higher room rate for foreign inpatients (e.g. Sripat in Chiang Mai), or might try to divert foreign patients to after hours clinic, which cost much more than public channel. (Thais also pay more to use those.) Even with the above, government hospitals remain less expensive than private. Private hospitals: it varies widely. Many charge everyone the same (high) price but some -- especially in touristy areas -- have double or even triple tiered pricing. Worth noting that overpricing in private hospitals is a frequent complaint from Thais and intermittently in the press as an issue (again -- for Thais. ). Periodically government attempts to do something about it, to date with little to no effect. Mark up on drugs and medical supplies is especially obvious and egregious. One can largely avoid the former by not getting medications from the hospital, buying from outside pharmacy instead.

Usual rate at private hospitals is 20-30k. I've never seen it priced as low as 10K. Was this a government hospital?

It is customary in Thailand. I can't say re other places.

It certainly makes sense to do a thorough eye examinstikn first. There are other conditions which can co-exist and have implications for cataract temoval. EKG, fasting blood sugar and CBC are pretty standard and if you have had done in past 3 months they may accept that report Alternately you can get it done at an outside clinic and submit that. They just want to rule out diabetes infection or heart problem. You are unlikely to get cataract removal for less than 80 - 100 per eye at a private hospital in Bangkok. But government hospital will be around 25k assuming standard lens.

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First I have heard of it. Perhaps neely opened? Appears to have just one doctor. In Bangkok by far the best private place to have cataract or other eye surgery is Rutnin Eye Hospital. https://www.rutnin.com/en/home/ If hovernment facility pteferred then either Mettapracharak Eye Hospital in Nakhon Phatom Or Metta International Eye Hospital in Bangkok (affilated with the above)

The dosage range for tamsulosin is .4 - .8 mg daily. Since you are already on DuoDart which contains .4mg, you would add no more than another .4mg to that. It is usually taken as a single dose, true. Assuming you take the DuoDart in the morning, doctor may have suggested the additional .4 at night to help maintain blood levels through the night since this is when your symptoms are worst. Best to ask him rather than try to second guess about it.

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If you have had an epidural injection then presumably you have had xrays & MRI to identify cause of the pain. What did they show and how recently were they done? And how recent was the epidural? I ask because degenerative spine conditions change with time. Stem cells and PRP for back pain are still in investigative/experimental stage. Basically your options are (1) see top spine specialist for new or second opinion regarding cause of the pain and best treatment and/or (2) see physical therapist. Ideal would be both, and in that order. But for PT you'd need to be in BKK for a while, how long will you be staying?

No indication that this speciric accident occurred on Koh Tao. Nothing said about where in Thailand it occurred.

All of the brands I listed are registered with the Thai FDA

The OP has had a thorough workup in the UK and a bacteria was cultured. Unfortunately it is resistant to many drugs and he was advised he needs a prolonged course of intravenous therapy with a costly class of drugs called carbenams. This resistance very likely results from prior (incomplete) treatments and attempts at self treatment so others should take note.,

Actually rosuvastatin does have some advantages over simvastatin. Matters more for some patients than others. Especially advantageous if triglycerides are elevated as well as LDL. Many patients will do fine on Simva or aotrvastatin, but some do need rosuvastatin. The poster should discuss with his doctor where a change to Simvastatin would be appropriate in his specific case. There are now many locally made generic forms of rosuvastatin now in Thailand. Brand names: Cholestar Crestatin K-zuva Otagil Rosetta Rostatin Rosuva Rovas Surotin Many of these brands cost less than what that poster is taking (Vivacor, an import) . For example, Rosetta 10 mg is 365 baht for box of 30 here https://bangkokdrugstore.com/product/rosetta-rosuvastatin-10-mg-box-of-30-tablets/

Costs of care under Medicare will be the same anyplace since Medicare sets the rate. The only locality specific issue in mecical costs is the availability of doctors who will accept Medicare. Avoid NYC for sure. And of course, living costs vary greatly by locality but for that you might prefer to look at places you have friends you might stay with. If you do nto have any friends anywhere, then the combination of inexpensive lodging plus good availability of doctors/hospitals would be key, and as you'd likely also nto have a car, that means a comparatively inexpensive city. Note that there is a penalty for late enrollment in Part B, Part B is not so much for catastrophic coverage as all outpatient care. In the US that is a lot as hospitalizations are kept very short, with much care done as outpatient.

Virtually everything is covered, inpatient and outpatient. Main exception would be drugs not on the MoPH list. Other exception are some medical devices, for example the special catheters used for cardiac ablation. You can find that list here, but it is not complete as they are constantly adding to it . ALso some drugs I don't see on it, nonetheless people seem to get under SS. Whether because added more recently or hospitals just don't bother to charge, I am not sure. https://pubmiddleware.mims.com/resource/document/82AE6301-4B56-473D-A76E-ADA40096A174/pdf/MIMS_1_2022

The OP has had this infection many years and long ago maxxed out on common antibiotics like doxy, bactrim etc. Even quinolones. He has multi-drug resistant infection responsive to only a small range of new antiobiotics that must be given intravenously.

Do not bother with anything other than the antibiotics listed as S. Doctor might want to repeat the culture before treating since report is old and may (should) repeat after treatment. That and maybe a PSA are all I would expect by way of tests and they are not costly. It is the medication that will cost. Your main issue will be persuading them to let you come daily for infusion rather than being admitted to hospital.

Please see pinned thread https://aseannow.com/topic/839185-rehab-options-for-alcohol-andor-drug-addiction-in-thailand/ However you are going to find that the sort of place you have in mind is extremely expensive here. Possibly more so than in the UK or Spain with much less success rate. Other than Wat Tham Krabok and New Life they are all very much for-profit "luxury" places. You are right to be concerned about Wat Tham Krabok's extreme approach, it needs an iron will and strong physical constitution to get through that and it lacks medically trained staff to deal with physical effects of detox which can be severe, even life threatening . . ..especially in an older person. New Life is not set up or staffed to deal with physical detox, it is more suitable for people looking to make a new start after having already detoxed and also is very much centered on Buddhist theory and practice, might not make much sense to someone who does not have that background. Also English speaking can be a bit limited as it is oriented to Thais. So that leaves the "luxury" places. Of these, the Cabin is the longest-standing/ probably the most experienced. Or else somewhere other than Thsiland. There are quite a lit of places in Spain though I can't suggest one over the other.

If I recall correctly you had a culture & sensitivity which showed the organism is resistant to most antibiotics including sulfonamides. Treatment should be based on that not what helped other people whose pathogens likely differed.

Moved to the "Off the Beaten Track" COVID vacvine sub-forum in light of large amount of factual misinformation

SSO will cover it if a doctor at your nominated SSO hospital prescribes it