Sheryl

Comparing doctors in upcountry locations with, for example, the best available in Bangkok (where there are urologists with the suffixes you mention and US equivalent) is comparing apples and oranges. That said, the range of treatments for BPH available here is more limited than in the West with several types still not available and others (e.g. Rezum) available in only a few places and likely still on a learning curve.

There is now (new) a way to get a pdf file showing that you did the report. What you do is first, do a search for the report you entered. on the main screen just put the report dayte (date informed) then selcting "all" search. The result will show at the bottom of the page as a long single row of data. Then on the far left where there is a search icon next to the person's name, click that and you get the whole report showing all the details. At the bottom towards the right there is an option to "export", clicking that s supposed to download a pdf file showing the report submisison. So far though all I get is a "Service Timeout" error message.

"Genuine Cialis" is incorrect terminology when what what means is genuine Tadalafil i.e. generic equivalent to Cialis but not Cialis itself, that is a specific brand. Tdalafil has several different uses. Lower doses (2.5 mg, 5 mg) are for use in tretaing BPH. For ED, dosage is 10-20 mg. The only time it is used in dosages over 20 mg is for pulmonary hypertension ,a serious condition that must be managed by a cardiologist. For that purpose usual dosage is 40 mg. Hard to imagine why 60 and 80 mg preparations would be sold. In any event, wherever procured from, do not take more than 20mg when using it for ED.

Not remotely sounding like anything to do with Paget's disease, which is a bone condition. Skin lesions are not a feature in that condition. Are you sure she said Paget's Disease and not Psoriasis? (Which unlike Paget's is a a condition with skin manifestations, and relatively common in Thais). There would be no reason to see a skin specialist with suspected Paget's disease.

What is for search was the part you initially showed in your first post. Indeed, if on the left hand side (not shown in your initial post) you click "add" on bottom left it brings up the section for registration -- but in my case (not yours) instead of showing the address in the box there was an error message saying I need to add an address in my profile. But the address is already in the profile. Hence my problem. I have since resolved it. Although everything on initial profile page was completed (including my gender, a new field) what I had to do was click "edit" next to the existing address and then go in and re-enter my gender again there. in Chrome This solved it and I was able to submit rteport. Now struggling to get it to export the proof of submission...I keep getting a "Service Timeout" message. Will try again in the morning I tried Chrome, Safari and Firefox. All the same issue.

What was suspicious was all "have no money or insurance" part. Your OP did not ask about whether it was life threatening etc nor what the treatment was, rather seemed focused on the money and insurance issue and where to go. She has health cover. Where to go, is as explained, the government hospital where she is registered under the 30 baht scheme. She will have to explain to them what her symptoms are. She cannot possibly self diagnose Paget's disease. Do you have any idea what gave her that idea? As she cannot walk into a hospital and just announce she has Paget's disease and ask to be treated for it. She will have to explain what her symptoms are and let the hospital go through its own diagnostic processes. Depending on what level of hospital this is and what her symptoms are they might or might not need to refer her onward to a higher level hospital. The work up is very, very unlikely to lead to a diagnosis of Paget's disease. That is rare overall, and especially rare in Asians and in people under the age of 50. The odds of an Asian women under 50 having it are extremely low. Paget's disease is chronic but manageable with treatment and prognosis for a full life, with treatment, is good. It is managed by an endocrinologist. But she almost certainly does not have it. If you can find out what (1) what the symptoms are that led her to make this self-diagnosis and (2) which hospital she is registered at under the 30 baht scheme I can better advise.

I saw that. Burt all the required information is already entered. There are no empty fields in the profile. And the whole thing was set up and approved after the last update.

You would think so, but it does not accept it, it gives me an error message that it needs address. If you look to the left of what you have shown there is a box that lists approved addresses. Mine is there. But if I fill out the rest and hit "add" I get this error message. Actually the part you are showing is to do a search, not to make a report. That comes up when one clicks "add" to the left of what you have shown. But I then get the error message about need for address in my profile, even though it is already there.

I was trying to use my approved account to submit a TM30 report But I get the error message that I need to add address where the person is staying in my profile - even though it is already there (and thus cannot be re-added).

Really hope someone can help. I have successfully registered but am stuck trying to submit a residence report. On the main page where it says "Inform accomodation >Search" the box on the left hand side shows my address as approved but the address bar is blank. Clicking "add +" does not add this to the bar (unlike what is shown in the User Guide) nor give that address as an option to select. Rather, I get the message "Please add "The address to receive foreigners to stay" at Profile Page" even though the address is already in my Profile page. If I try to "add" I get the error message "The address to receive foreigners to stay data Duplicate" because of course it is an exact duplicate of theo ne already listed. ??????

Going through the government system cannot choose the doctor. If she wants recommendation for a specific doctor at a private hospital I can provide but looking at >800K cost (assuming valve replacement needed)

All Thai citizens not covered by other schemes are autonatically covered by the Universal Health Scheme (AKA 30 baht scheme) and all Thais know this. Which makes her approach to you a bit suspect. She needs to go to the hospital where she is registered under that scheme. Which is generally based on house registration so might be in her home province. (House registration can be be changed but if she is renting needs the cooperation of landlord). Paget's disease is rare cannot be self diagnosed. Treatment in the unlikely event she actually has this condition would be available at university hospitals like (in Bangkkj) Siriraj and Chulalongkorn.

I can't say re locally available brands but I get unsweetened California Gold Nutrition brand on iherb. Delivery is pretty fast (under 2 weeks) and costs a bit less than locally. I started using this about a month ago to see if it will help with increased muscle stiffness first thing in morning and after car rides etc now that I am older and upon reading this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073774/ Maybe coincidence but it is better since I added this supplement.

I got the same thing using Google Chrome initial;ly, on closer inspection it was at site www.aseannow.com whereas correct site is https://aseannow.com Try correcting the URL

total cholesterol is irrelevant. Your LDL is definitely too high (optimal is under 100; anything above 160 is dangerously high). So you need to get that down. If as it sounds from your post you are not going to be able to do that with lifestyle modifications then medication is advisable. A statin would normally be tried first but if it does not suit there are other drugs that can be used instead e.g. niacin, fibrates, ezetimibe etc. What is your triglyceride level? And what is your Hb1Ac? You cannot assume good cardiac health just because you are physically active. A cardiac calcium test or stress test would be advisable and results could help inform target LDL levels and medication decision.s

Part C is a Medicare advantage plan. Basically a private HMO which covers whatever Medicare would cover (but often with restrictions like needing a referral for a specialist or limited number of doctors/hospitals you can use which in turn can mean longer waits to be seen). Sometimes these plans have some added benefits not in Medicare but these are usually not much in substance. On the whole Medicare Advanatage plans are inferior to basic Medicare coverage and certainly to basic Medicare plus a supplemental.... but they may suit some on very tight budgets. Medicare Advantage Plans, if they cover care overseas at all, will do so only for emergencies. Also note that you must live in the plan's US coverage area at least 6 months of the year. If it is discovered you are actually resident on Thailand the plan is void.

For the countries that do not issue the income letter, if using the income method you need proof of income remitted every month from abroad. Some IOs will accept a bank statement, some want ti see the bankbook some want both. Alternative is the lump sum in the bank method.

He is referring to a letter from his Embassy attesting to his monthly income. For people who come from a country whose embassy provides this letter, it is accepted as proof of income with no need to show bank statement. Nor is there a requirement to bring it all into the country. US and UK Embassies, and I think 1-2 others, will no longer provide this letter but many other embassies still do,

There is an uncommon form of psoriasis that follows a linear pattern but I am not sure it looks like this. Anyway to answer your question: no, this is not normal. You really need to see a dermatologist.

I am really starting to think maybe there is just a misplaced decimal point or "cm" where it should have been "mm" as surely any doctor would mention it if size was really 4.9 cm. That is larger than a golf ball!!! A 4.9mm gallstone on the other hand, is unremarkable and in an asymptomatic patient can certainly e managed expectantly i.e. no need for surgery until/unless symptoms arise. Bring the CD with the ultrasound to a surgeon and let him review it. Or, return to same hospital and ask for clarification.

You get part A automatically (assuming you qualify; most people do). No need to pay any premium. It s Part B that you need to opt into, and there is a cost for that. Currently I think around $170 a month. Can be automatically deducting from your SS. Important to note that if you do not get Part B when you first turn 65, and then later enroll, there is a penalty in the form of higher premium and it is applied for life. I enrolled in part B because of this though have virtually never used it so far ... I like keeping options open and I may return to live in the US at some point though not imminently. I mainly use Part A preventive care benefits (annual check-ups, periodic colonoscopy, mammogram etc etc) , though on occasion have had to dip into Part B for a few preventive services not covered under A. I have not used ti for any illnesses thus far but good to know it is there as a back up to my international insurance especially as this includes an exclusion. Under both parts A and B there are deductibles and copays such that if fulltime living in US it is advisable to get a Medicare supplemental insurance or Medicare Advantage Plan, former is better but more costly. Neither is possible while living abroad. One would also need to get a Part D plan (to cover drugs), not necessary when living abroad.

Yes, it is a unusually large gallstone. Virtually qualifies as a "giant gallstone". there are only a handful of cases in the entire literature of stones >5cm. Even above 3 cm is rare. Stones of such size carry unusually high risks of serious complications, which is why the usual approach to asymptomatic gallstones (expectant management i.e. wait and see) does not apply. Again, assuming the size estimation is correct. Not unheard of in my experience for a Thai report put cm instead of mm (or instead of decimal point cm) so some possibility of error there. Do you have with you the actual ultrasound report and copy of images, either hard copy or on disk? Did the doctor mention it was a very unusually large stone? re Dr. Narongsak, I originally found him about 10 - 15 years ago when a distant relative needed a hernia repair. Coming from Cambodia so government hospital not very practical, yet cost was a consideration so looked at St Louis and reviewed qualifications, selected him based on training, experience and publications. I was very favorably impressed when we then met him. Since then over the years I have referred many board members to him with continued good feedback. He is very experienced and competent, open to questions and patient concerns, unassuming and kind.

@QuantumQuandry It is never the hospital that matters but the doctor. In the case of laparoscopic GB removal, any general surgeon trained in laparoscopic procedures who has done many of them (i.e. several years and around 50 procedures or more) would be well able to do this, Cholecystecomies (GB removal) and hernia repair are the "meat and potatoes" of general surgery. The various hospitals you mention do not differ in medical quality. They do differ greatly in amenities and degree of English spoken especially among nurses etc. Also differ in ease of use, wait time etc. If you want a specific surgeon recommendation at a private hospital that is (compared to other private hospitals) reasonable in cost, I suggest Dr. Narongsak Jongsiri at Saint Louis Hospital in Bangkok (Sathorn, on the BTS). https://saintlouis.or.th/en/index He is very experienced in laparoscopic surgery and also a very nice and sincere man. With excellent English. ST Louis is a solid, "no frills" non-profit private hospital. Last I heard laparoscopic GB removal there was around 180k. As I have said before, I do not know if lapaorscopic surgery is available at Queen Sirikit. The only way to find out is to go in person and consult a surgeon. You will have to go in person to get an appointment, waits will be long, a lot of red tape, and other than the surgeon (and even there, no guarantee) little to no English speaking. However this will certainly be the lowest cost option for you without traveling far afield. As to whether the 5 cm size of your stone precludes laparoscopic approach: not if the doctor is sufficiently skilled and experienced. But there are other factors as well, including your weight (obesity makes laparoscopic more difficult) and whether there are any abdominal adhesions (more likely in people with prior abdominal surgery.) There is always a possibility that the surgeon may have to switch from laparoscopic to open approach mid surgery if he runs into difficulty, and in that case you still pay the rate for laparoscopic surgery. Best to discuss with surgeon how confident he personally feels about lapaorascopic approach in your specific case all factors considered. Regarding your question about diarrhea as an after effect of the surgery, the occurrence of any diarrhea after removal of the gallbladder is about 13 - 20%. The vast majority of this is temporary (days, weeks or less often a few months). Permanent chronic diarrhea affects only a small percentage of patients, I cannot give an exact number as most studies do not do follow up longer than 6 months but it would certainly be well under 10%. It is not zero, though. As previously explained the issue with asymptomatic gallstones of >3cm size is that they are more likely to cause blockage of the common bile duct in future than are smaller stones. However the decision to operate on large asymptomatic stones requires an overall assessment of many factors including the specific patients' age , other co-morbidities, whether there are any specific surgical risk factors, and whether the stone is pigmented or radioopaque. Also need to consider how readily the patient can access immediate medical care in future if a "wait and see" approach is chosen. Alternatives to surgery, aside from just "expectant" management, are: 1. Oral dissolution therapy: Medications that medicines that contain bile acids are used and it takes many months or even 1 year. This works only if the stones are made of cholesterol, which would show up as radiopaque on the ultrasound. that can break up gallstones. It will not work for pigmented stones as these are not made of cholesterol. 2. Lithotropsy (shock waves) are rarely used, and only for smaller stones so not an option in your case. You really need to be having this discussion with an experienced surgeon who has access to your full medical history and ultrasound report. Note that everything I have said assumes the stone size you mentioned (almost 5 cm) is correct and that you did not mean 5 mm.

While it is true that surgery is usually recommended only for symptomatic gallstones, with very large gallstones (i.e. >2 cm) it is advisable to remove. The problem is that they can end up blocking the common bile duct causing severe complications. I do not know if Queen Sirikit can do laparoscopic surgery. If they can, should be fine. Otherwise you might inquire at Phyathai Sri Racha or Samitivej Sri Racha, both are likely to cost less than Bumrungrad and would surely be able to do laparoscopic.

A hotel would not copy a prior TM30, no reason to, they need to make their own TM30. Which reception can do, using smart phone if need be, just from the passport info that they photographed. I have never, in over 30 years here and countless hotel stays at every rung of the ladder, had a hotel check my visa. Normally they just copy the face page of the passport, which is all they need to file the TM30 online. In small up-county Thai places which seldom have any foreigners, sometimes they do not bother with this either.