Sheryl

Manidipine is for high blood pressure, not diabetes. Swollen legs & feet is a common side effect if this class of drug (calcium channel blockers). Common, and inexpensive, alternatives are ACE inhibitors (e.g enalapril) and ARBs (eg losartan) Hydrochlorthiazide is a diuretic that also reduces blood pressure, though for most people this alone will not suffice and it rather needs to be taken along with abother drugs such as those mentioned above. How high is your BP?

There is no specific rule, but some Imm Officers take a dim view of people spending more than 180 days per year in Thailand, and many will at least question a back to back entry. Basically they have been instructed ti be on the lookout for people who are actually living fulltime in Thailand without appropriate visa i.e. using sequential tourist visas or vi=sa exempt entries etc to live here. In typical Thai government fashion this instruction came with no specific criteria so each IO makes up their own interpretation of what would suggest someone lives here. Zeal of enforcement also varies btoh by individual IO and over time. What you propose to do, 60 days here, 2 months away, another 60 here, should be fine.

Locking in the moisture that otherwise seeps out the pores is exactly the point of using it. But best nto to have it on 24/7. As it is also messy to use at night (smears the pillows) I usually suggest just day time use.

Went low was after significantly increasing dose and then using new vial. Pretty clear to me that it was the old vials - based on which he upped his dose - that were the problem. Decreased efficacy, likely due to heart exposure which could happen in transit to the hospital or through a on-off staff error in the pharmacy. For that matter might even have happened at home, for example if power went out at night while asleep, or during day while not at home, you might now realize it, Moral of the story is if you have been stable on an insulin dosage for some time and then start getting high BS readings, try a different vial batch before changing dosage.,

It is not. It is an offshoot of Allison Monkhouse, an Australian funeral agency with an excellent reputation which branched out into handling deaths abroad about 30 years ago. Has been awarded for its free relief work, e.g. during the Asian Tsunami. Head office remains in Australia. But large regional office in Bangkok has been operational for at least 20 years, maybe more., originally under the name Allison Monkhouse Co, Ltd. (Thailand). I have dealt with them directly and also referred people there, consistently good results snd very reasonable costs.

With US Embassy, in case of death of a US citizen, you can call 24/7 and get through to the Duty Officer, it is one of the most common tasks a Duty Officer has. You'll have to go through the general switchboard first, key thing to say are if it is after hours is "need to speak with the Duty Officer to report death of a US citizen". During working hours would just ask for American Citizen Services. Besides providing various lists, the Embassy will facilitate contacting next of kin in the US if needed, and also if needed facilitate communication with local authorities for family based out of country, of family in country who need help (translation etc). - has to give the green light for release of the body (which they will only do upon instructions from the Next of Kin. )There is form for identification of Next of Kin which can be downloaded on Embassy website. - will issue a "Consular Report of Death Abroad" which serves in lieu of a death certificate in the US. A Thai death certificate, even with notarized translation, will usually ot be accepted by US financial institutions and authorities so this document is critical. Even if there are absolutely no assets in the US, one would want this to claim the Social Security lump sum death benefit and (if applicable) survivor benefits. See https://th.usembassy.gov/u-s-citizen-services/death-of-a-u-s-citizen/

They are Thai based. Office in Bangkok and excellent, sensitive staff. Asia Division – Bangkok Office Bio House Tower, 3rd Floor 55 Soi Phrompong, Sukhumvit 39 Klongtan Nua, Wattana Bangkok 10110 Thailand Office: +66 (0)2 258 5946 Mobile: +66(0) 92 859 5616

I would add to the above that, although it is listed as a peer-reviewed journal, the qualifications and affiliations of the authors are less than clear to me. They seem to belong to the "Nagoya City University and Institute for Consumer Science and Human Life" which despite its name seems based at Kinjo Gakuin University, a small private women's college. I can find no information on this Institute other than other articles written by the same people in online journals (all of them of similar bent). Website for Nagoya University does not mention this Institute under any of its faculties that I can see. From the article, the authors have expertise in pharmacology but not epidemiology and many of their hypotheses simply do not fit what we see happening in the real world, epidemiologically. There ave been innumerable long term prospective studies related to coronary artery disease and if in fact stain use increased its prevalence or severity this would have been apparent by now. The journal this appears in is one of pharmacology not epidemiology or cardiology. Which is not to say statins are totally benign or should be used indiscriminately. But the propositions in this article are far fetched to say the least. Between an in vitro lab finding and actual impact on living organisms there are many steps and factors. The Co-Enzyme Q10 depletion mentioned is well known. Use of Q10 supplementation for patients on statins has been proposed and is routine in Japan, but several random controlled studies have failed to show any effect from it. These however focused on muscle pain and muscle related changes, not coronary effects. Nonetheless no harm in taking a Q10 supplement and personally, I put a family member with CAD who requires statins on it.

Would your insurance cover the 190K at Medpark Hospital? Note too that when there is an issue with insurance typically it gets resolved in negotiations between the hospital 3rd party payment opffice and the insurer. Often the hospital ends up reducing a charge or "repackaging" the breakdwon. I would not expect that from an upcountry private hospital (those are usually best avoided for a number of reasons) -- especially one that came up with such seemingly odd cost estimates to you -- but big hospitals in Bangkok, yes.

It is. And it is the OR charge that should be dramatically different between laparoscopic and open since no need to use endoscope for the latter

These quotes are quite high, and difference in price between open and lap should be much greater (typically at least 50K). Even the laparoscopic is less expensive at top hospitals in Bangkok e.g.190K at Medpark https://www.medparkhospital.com/en-US/packages/laparoscopic-hernioplasty and 219k at Bumrungrad https://www.bumrungrad.com/en/packages/laparoscopic-inguinal-hernia-repair-1-side Open is not listed but would be usually around 150k or less And of course government university hospital would be less still

I can't recall specifically for hernia but there are AN members who have used hospitals in India. You need to research both the hospital and the specific surgeon carefully as in India, like anywhere else, quality varies greatly. The price you were quoted could not have been for open or laparoscopic as the 2 have very different costs. I expect it was for laparoscopic. It is not routine to require a CT scan first unless there is doubt about the diagnosis which is not usually the case. If I were you I'd consider going to Khon Kaen University Hospital, quality is good and cost will likely be similar ti going to India once you take into account airfare etc. Not that should not fly for at least 48 hours after laparoscopic surgery and a full 10 days after open surgery. And sometimes even when laparoscopic is planned they have to switch to open during the procedure (especially likely to happen in patients who have had prior abdominal surgery or re obese). In other words you might ave to stay longer than planned in India afterwards.

I meant that use by people who do NOT have coronary artery disease is of less clear benefit. You DO have CAD and there is no question but that you should continue the prescribed statins. The source is a peer-reviewed journal. However the authors repeatedly stress that this is a hypothesis of what may be the case. It is a controversial article.

They have the same action. Atorvastatin is somewhat more effective but also also has a higher incidence of side effects. https://academic.oup.com/qjmed/article/92/7/387/1696923 https://pubmed.ncbi.nlm.nih.gov/10687671/ Simvastatin can not be given at a "high intensity" dose while atorvastatin can so for people needing very high statin doses atorvastatin is preferred. If your atorvastatin dosage is 20 mg or less, and you have good results on that, then discuss with your doctor if Simvastatin could be taken instead. Note that there is a 2:1 dosage equivalency i.e. 20 mg Atorvastatin = 40 mg Simvastatin; 10 mg atorvastatin = 20 mg Simvastatin.

Atorvin (made by Unison) Chlovas (made by Millimed) Lipostat (made by Siam Bheasach) Will run about 500 baht for 30 tabs

1. Use a very mild soap like Pears 2. Apply vaseline to the dry areas, it is by far the best thing for dry skin though a bit messy. Are you sure it is dry skin and not some other skin condition?

And the "they" that come are fully trained and equipped EMTs. Who will provide immediate stabilization right on the scene as wel las in the ambulance while in transit. Not the case here.

Moved to the Health forum. You have gotten some suggestions for psych but I would also suggest you see this doctor at Sripat https://sriphat.med.cmu.ac.th/en/doctor/detail/26 what you describe sounds much like fibromylagia. Most Thai doctors are not familiar with it, and the "must be stress" is a default response when they can't find a cause familiar to them The above doctor is familiar with fibromyalgia. See what he thinks. Anxiety can do a lot but is unlikely to cause the sort of widesprerad nerve pain you describe.

Khin Kaen University Hospital (Srinagarind) Prof. Tanita Suttichaimongkol https://srinagarind.md.kku.ac.th/ Must say I am puzzled by "They found nothing serious in her stomach apart from an ulcer." An ulcer is serious, and would certainly account for burping, pain after eating etc. Did she have a repeat endoscopy after treatment for the ulcer? And repeat testing to ensure the h. pylori was eradicated?

Thsi particular train route is both very infrequent and very (unusually) uncomfortable. Unless it has recently changed, just hard wooden seats (sometimes with no free one available) and no a/c. It is also really slow. Forget what the schedule says, it will take a good 6-7 hours easily just to reach the border, sometimes 8. Allowing another hour for passing through both immigration controls (with a 1 km smelly walk between the two) and about 4 hours from there to Siem Reap, you are talking about a 12 hour trip i.e. a full day each way just for travel. The crossing at Poipet is highly unpleasant - place is filthy, full of beggars and assorted bad characters/touts; corrupt immigration officials. The taxi ride from Poipet to Siem reap also rather uncomfortable not to mention dangerous. But the worst of it will be reaching Cambodia from Bangkok. I really suggest you fly from Bangkok straight to Siem Reap, Air Asia, Bangkok Airways, Thai airways all offer this route. 1 hour and you're there. There are packages available that include flight + hotel, and/or flight + hotel + entrance fee to Angkor. Might be worth pricing these. If by "our 4 guests will have visas on arrival" you actually mean they will be entering visa exempt (a different thing), yet another reason not to pass through Poipet/Aranyaprathet, that crossing is notorious for giving people coming visa exempt a hard time. No problem at all flying in.

The only drawback is you will have to file a tax return (currently not required if you owe nothing at all). And may need, at least the first time, the services of an accountant well versed in the DTA etc to know how to show the fact that the SS is exempt. If you have a US credit card that you can pay out of a US bank account, making more use of that for larger ticket items might help you stay within just your SS. Alternatively, transfer some extra funds as a cushion now before the new rules go into effect. in order to be extra sure I can live solely on my SS I have switched to use of US card when buying air tickets to abroad and for my (internationally based) health insurance. In both instances, though I do the transaction from Thailand the funds never enter Thailand at all, except/unless I use a Thai air carrier.

Depends on your condition. On the scene interventions of the type people are used to from EMTs in their home countries are rare here so there is less value to having an ambulance vs getting to hospital on your own if that is physically possible. I would say, if able to walk at least short distance, and if there is no contraindication to being moved (as in case with possible spine injury etc) Grab taxi (or equivalent - app that lets you input the destination) to hospital of choice is best as you will reach the hospital and thus start treatment sooner. good idea as well to think through ahead of time what hospital you want to go to in an emergency.

Unfortunately this is true. A service here in Thailand followed by cremation (possibly a few close relatives from US could fly in for it?) and then you travel alone back to US with the cremation remains for a fuller service is probably best option.

Sending the body is indeed very, very costly (and complicated). In fact would probably cost less for key family members to fly to Thailand to attend funeral than to do that. Sending cremated remains is very easy. You can even take with you as accompanied baggage, I have done it. This agency can help with everything including cremation or body preparation, the Embassy paperwork (you need a Certificate of Death Overseas from the Embassy and the Embassy in turn needs local death certificate etc to issue it) . They are every good and will not try to upsell you anything: https://www.amarinternational.com/contact.html Sorry for your loss.

@mikey88 also need to consider how ambulance would get into his place - if he is serious enough to need one, might not be able to get to the door. He should consider giving a copy of his key to a trusted neighbor , preferrably one who speaks both English and Thai.