Sheryl

An ultrasound, which is considerably less expensive than a CT, would be more usual with CT only if ultrasound findings inconclusive.

As FBN has said, it is important to get this evaluated to rule out appendicitis and other potentially serious conditions.

OP if you would like a recommendation as to doctor/hospital, pls advise your location

I would further add that there are quite significant dangers with some of the commonest treatments for GERD by conventional medical treatments.

PPI's have come under close scrutiny in a few studies of late for their potential problems when taken long term.

In fact they might actually contribute to cancer according to this researcher.

The problem being that PPIs mask the symptoms of severe GERD and so damage is being done to the sufferer but they are unaware of it.

http://www.sciencedaily.com/releases/2011/07/110718161333.htm

Totally misleading post.

First of all, please do not post excerpts from the popular press as if they were scientific articles, even if they purport to be reporting on same. Post the original, actual article from the actual scientific journal. Popular press extracts are often inaccurate.

Secondly, the article referenced most definitely does not say or imply that PPIs "contribute to cancer". What they do say is that patients who obtain symptomatic relief with PPIs may be less likely to have endoscopic tests and thus some cases of Barrett's esophagus may not be detected. The researcher's conclusion is not that PPIs should be avoided, but rather than all cases of GERD, even those which get adequate symptomatic from conservative measures, would benefit from periodic endoscopy to screen for pre-cancerous conditions. Same would logically apply to cases of GERD which get symptomatic relief from herbal/alternartive ones.

Numbness and weakness in the hands is not always (or even necessarily usually) due to a problem in the cervical spine. It can have a large number of causes, including local nerve compression (usually from repetitive stress injury) and various neurological conditions.

From his last post, the OP has already seen a doctor who has diagnosed a repetitive stress injury.

OP, you may find that wearing wrist splints is helpful, especially at night and when typing, Can buy in a pharmacy.

Antiinflammatory drugs may also be helpful, presumably the doctor prescribed some.

In some cases steroid injections also help.

Should you want another opinion the best hand specialist in Thailand is Dr. Panupan who has private hours at Phyathai 2 Hospital once a week (call to verify).

It would be very unusual to prescribe 2 calcium blockers at the same time for hypertension. in addition, flunarazine is not usually used for management of hypertension but rather to prevent migraine headache and also sometimes in the management of epilepsy and cerebral vascular disorders.

Were the amliodipine and flunarazine really prescribed by the same doctor at the same time and for the same purpose? Or were they prescribed by different specialists for different reasons?

Combo of an ACE inhibitor and calcium channel blocker is common enough

Phyathai is certainly fine for this. Another and possibly even less expensive option would be St Louis Hospital.

My nephew had surgery with Dr.Narongsak there recently and we were happy with him: http://www.saintlouis.or.th/clinic/doctor.php?dr_id=767

He is a general surgeon.

How physically stable is she?

If not in need of medical stabilization, counseling can be had at:

http://www.ncs-counseling.com/how-we-work-at-ncs

Otherwise, Manoram Hospital has the most extensive range of psychiatric care in Thailand. Unfortunately their website lisitng of doctor qualifications is not very helpful so would have to contact them directly to find out who specializes in this:

http://www.manarom.com/index_eng.html

AQS wants you to come not more than 3 days before the day of departure, though if they are not busy they will accomodate you 4-5 days before (but you risk being sent home & told to come back). When they get busy they give priority to whomever is leaving soonest.

Note that they close for an hour for lunch and then at I think 4 PM. And are closed on all government holidays

Yes, either Sara Lee or bake your own. They are very easy to make. Some recipes do not even require baking and are still better than anything you'll get in a restaurant here.

Thai-made cheesecakes are a travesty.

Sheryl,

Do you know the quality of the Phuket (foreign and Thai) bakeries?

I've sampled quite a few over the years.

I haven't found a cheesecake in any (nor in Bkk, nor anywhere else in Asia) that is a proper cheesecake by my standards.

But I am from NY so my Cheesecake standards are pretty high,

Fair enough, but to be clear, you're talking about Phuket, right, where you have sampled quite a few over the years?

Yes. (And everywhere else in Thailand too).

Be warned that if you color your hair, you need to have it done before the keratin and preferrably at the same shop -- do not self-color, the keratin will wash the color off entirely (did to me).

Also be warned that after keratin treatment your hair may be more resistant to coloring, at least mine has been, badly enough to put me off keratin in future. (I'm blond with very fine hair, which may be a factor -- apparently brunettes respond a bit differently).

Still need to consider how you will pay for healthcare.

jrtmedic and I were responding to pinfold.

Your situation is crystal clear and you did nothing at all wrong. In the future absolutely do not use doctors who show this type of rudeness nor hospitals that will give clear advance info on costs.

In this instance from the sounds of it the doctor was the problem because she was unwilling to take a few minutes time to make a simple inquery.

The US is a different situation owing to the fact that almost no-one pays out of pocket for care, so the whole cost thing is actually a prolonged and subjective negotiation between insurance companies and hospitals and there are no fixed costs, just a price that the third party payer ultimately agrees to -- which is almost never the price the hospital initially sought. It's a total mess. Some payers, like Medicare, have opted to just establish their own flat rates of reimbursement and stick to them as a result.

Bear in mind that when new technologies like this come out, there is a learning curve...and they are only as good as the operator.

Personally I would opt for conventional laser removal of cataract with a very experienced doctor than to be among the first 50 cases someone did with the new machine.....

There is a big dental school in BKK just down the road from Victory Monument.

I went there to have a broken tooth capped.

The job was done by a senior lecturer there and he did a great job, they even came and took a photo of my other teeth so they could match the color of the cap.

It took, if I remember correctly, 3 appointments, cant remember the cost but it was very reasonable.

Now I couldn't tell you which tooth it was.

.

Suspect Sheryl will know more about the place than I do.

That is the Mahidol Univ Dental Hospital.

Definitely the best source of low cost good quality dentistry but like all government facilities, long waits & some red tape.

There would be no reason for a cap or crown or bridgework if it is just replacing a filling. You need only the old filling removed and a new one put in.

Unfortunately the sort of thing you are looking for is more likely to be found in Pattaya or in Bangkok.

The clinic in Pattaya is specific to hormone therapy and thus seemed best suited to the needs.

In Sri Racha the two main private hospitals are Phyathai Sri racha and Samitivej Sri Racha. Both are very good hospitals. At Phyathai they do SRS so presumably their endocrinologist(s) would have experience with hormone therapy for transsexuals. Suggest you email their international Coordinator Gavin at [email protected], he is very helpful.

you might also consult some of the surgeons in the area who do SRS as they must have endocrinologists they work with/refer to. Try Dr. Suporn http://www.supornclinic.com/ (I realize you are not looking for SRS, but these people would be able to recommend an endocrinologist).

None of this is going to yield a clinic specifically for transgender health needs, but you may be able to find an endocrinologist with the appropriate expertise.

In Bangkok I believe there are some more comprehensive clincs for transgenders.

The Silom Community Clinic at Bkk Christian Hospital is specifically geared towards the LGBT community, though I think with more of a focus on HIV and STD prevention http://www.silomclinic.in.th/ (site is only in Thai)

Yes, either Sara Lee or bake your own. They are very easy to make. Some recipes do not even require baking and are still better than anything you'll get in a restaurant here.

Thai-made cheesecakes are a travesty.

A woman you have "lined up"to be your gf sight unseen via a dating site is not, I hate to tell you, in it for love or affection.

And women you have to send money to from home to keep available for you when you go back are also not what I would exactly call GFs. That's a financial transaction.

The thing about buying a woman is -- you end up with a woman who can be bought. Which among other things makes it highly likely she will either leave you for a higher bidder or seek to maximize profits by two-timing you.

Just come on your own and try to meet ordinary women, not ones on the prowl for a farang. By all accounts this is not at all hard to do. Try to learn to speak some Thai while your are at it, which also then provides an excellent conversation starter as you can ask women if you can practice your Thai with them.

You will certainly manage to have soem nice dates and who knows, you might acquire an actual GF.

You need an export license and health certificate from animal quarantine. For this you have to bring the dogs along with proof of rabies vaccination. It may take as much as 3-4 hours if they are busy so plan accordingly. (If they are not busy you could be done in an hour).

When you book with the airlines for bringing the dogs they may ask for the health certificate number, that is the only glitch with calling airline before going to AQS. Just tell them that you will be getting it on X day but want to be sure to reserve a spot sand that you will show the certificate at the time of check in. Some less experienced airline people will claim they cannot make the reservation without the number but in fact they can (I go through this all the time as I regularly travel with a pet).

The US requires that the rabies vaccine have been given in the past 30 days. Beyond that some states have their own specific requirements so best research that specifically. On the while the US is an easy place to import pets into.

The airlines will have requiremsents regarding the cage the pets are in, get that from the airline.

Yes...make your own. It is very easy to do. Whereas the quality of cheesecakes in Thailand is very poor.

I live about 1/2 time in Phnom Penh. Thai Baht ARE NOT widely accepted and the places that will take them give a very poor exchange rate. Change your baht to US dollars before leaving Thailand.

Conversely when leaving PP to return to Thailand if you then change dollars to baht you'll get a lightly better rate than you will in Thailand.

Along the Thai border area it's different and baht more widely used.

As others have said, no Bangkok (or other Thai) banks in Cambodia but plenty of ATMs about and these will accept international cards although at a charge.

While indeed proper diet and exercise are the key, I have found drinking large amounts of green tea first thing in the morning to be very helpful. By large amounts I mean a large potful of fairly strong green tea. With of course no sugar. About an hour after that I eat a brunch with no more than 300 calories in it and then nothing more till dinner, if I get hungry in the meantime I eat an apple, or unsweetened apple juice, or a carrot.

Some people report taking garcinia cambodgia (HCA) before meals also to be helpful, readily available in Thailand.

The herbal infusions are nothing more than laxatives and do not cause any loss of fat. Forget them. Figure out a way of getting more exercise on a regular basis and improving your diet...preferrably in ways you can sustain permanently. The weight loss will be slower but long lasting.

The reply you got from Bali is not answering your question, which they apparently did not understand.

If you are removing mercury fillings because of health concerns, be aware that the mercury in fillings is bound into an amalgam with silver, tin, copper, and zinc. These elements are tightly bonded together preventing the release of the individual components. In the course of having them all removed some of these bonds will break releasing mercury i.e. you will actually be increasing your exposure to mercury by doing this.

Studies have shown that the amount of mercury present in the mouths and blood of people with mercury fillings is negligible and also that most people with symptoms they attributed to mercury poisoning did not have elevated mercury levels at all. There is something of a rip-off industry in the West of persuading people they are being poisoned by the fillings in their teeth and then charging large amounts for "safe" removal. This industry is not present in Asia, most Asian dentists haven't heard of it hence your trouble conveying what it is you want.

A far better and safer approach would be to replace the fillings with composite one by one or a few at a time as they become loose or fall out.

Costs of health care in Thailand vary enormously. Sounds like Pinfold has encountered the large private hospitals in Pattaya.These are the highest prices to be found in the country. A 15 minute drive to Sri Racha, or a trip to Bangkok, and costs in private hopsitals drop dramatically. Or go to a government hospital where they are a fraction of this.

Quality of care also varies enormously, from world class to completely unacceptable. Need to do one's homework in selecting a doctor.

The medication is the least of your problems. Depending on what they are, you may be able to buy local generic equivaelents that aren't that costly.

Your big problem will be paying for health care, especially if you should need hospitalization which, with a history of heart disease, is likely to occur sooner or later.

Foreigners are not eligible for free health care in Thailand and even in a government hospital (where you will encounter red tape and language barriers) costs can easily run into the 6 figures for a catastrophic illness or accident.

Your prior heart attack will make it difficult to impossible to get local insurance as may your age.

And, you will loose eligibility under the NHS back home after living abroad for a certain period of time. I don't know the exact details on that but if you do a search in this forum under "NHS" you should find threads discussing it.

Unless you are able to self-insure by putting aside the equivalent of at least US $150-200,000 for use in a medical emergency I would not recommend this move.