Sheryl

The issue is not the initial sampling per se. It is the experience with skin cancer needed to recognize which lesions should be biopsied and how (there are different options depending on how high the index of suspicion is, which type of skin cancer is suspected and whether it is in a cosmetically sensitive area). If biopsy shows malignancy, expertise needed to decide how then to best proceed to endure complete removal with clear margins....and if it is melanoma (which unlike othrr skin cancers, can metastsize to internal organs) whether scans, lymoh node sampling etc is indicated. Experience/expertise needed on part of both the dermotoligist and the pathologist who interprets the biopsy. When it comes to skin cancer, which is comparstively rare in Thais, both are hard to find here. Doesn't help to have a biopsy done if the patholigist who reads it has seen very little skin cancer in their career.

https://bch.in.th/find-doctor/41 Seems very well qualified though I have no direct feedback on him Or, if you don't mind going to Phyathai 2 Hospital instead, I can personally vouch for https://www.phyathai.com/en/doctor/dr-panupan-songcharoen there only on Sundays. Treated me for carpal tunnel and later for elbow tendonitis. Besides being excellent clinically, he is a lovely and very sincere man.

For what type of problem (e.g. spine, knee/hip replacement etc). It makes a difference as there are sub-specialties.

ADHD is a genuine, recognized disorder. One that is both under- and over-diagnosed, i.e. many people have it but have never been diagnosed but there are also many inaccurate diagnoses/self-diagnoses of it made. Its diagnosis is complex and it can often be confused with various anxiety disorders. @Stevey your best source is the following in Bangkok https://www.manarom.com/index_eng.html I do not know the cost of assessment but you can email and ask them. ADHD meds (if indicated -- you might in fact have a different issue such as OCD or generalized anxiety disorder, hence the need for a comprehensive psychological assessment ) are strictly controlled in Thailand and must be obtained at a hospital ort clinic.

I think he means obsessive re-thinking and obsessive worrying. Obsessive and excessive. CXan be a feature of ADHD and also of anxiety disorders.

Medication would have to be ordered by a UK doctor. Showing medical records from Thailand (especially if it includes comprehensive test results) may aid the doctor but ultimately it is still UK doctor decision.

I believe this (very good) American doctor in Bangkok has maintained his US license. Contact the hospital to confirm https://www.mission-hospital.org/en/our-doctors/40-clinics-centers/internal-medicine-clinic/959-dr-nick-walters.html

effects are not immediate. Loading dose is 3 injections a month apart. Did you discuss your worsening vision with the doctor?

Was the Diamicron you were taking immediate release or modified release? Makes a big difference. I have only very limited information on Clazide but it looks like it is immediate release. Should never switch from modified or extended release medication to an immediate release form without first consulting a doctor as dose and frequency may need adjusment. There are 3 forms if modified release Glucazide available in Thailand but all are 60 mg not 80 mg Diamicron MR 60 (60mg not 80) imported Glucazide MR-60 ( 60 mg, locally made) Glycon MR (also 60 mg locally made) There are also combined metformin and glucazide preparations. I am puzzled that you say you were taking Diamicron 80mg. While it exists, it is not registered for use in Thailand, only the 60 mg MR formulation. Do you happen to have a picture of the box? If you were in fact taking 80 mg of glucazide daily but are now experiencing symptoms of hypoglycemia at same dose, and if both were immediate release preparations, then your requirement may have changed which is not unusual with diabetes management. Risk of hypoglycemic doelld is alwsys greater with immediate release preparations. The best thing to do is to consult a local endocrinologist or internist for advice. They will be best positioned to know what medication preparations are locally available, how their actions compare, and to advise you. Bring recent lab results if you have them. Where in Thailand do you live?

Absolutely what I would do. Be sure to have a one year statement from the bank showing the monthly deposits from abroad, as well as copy of the bank book and bank letter confirming the acocutn balance. Nothing has changed in the rules and there is no requirement to use specific banks. I would also cease using this attorney, for anything.

"pinched nerve" is a lay term and refers to compression of a nerve which could be anywhere in the body and from many very, very different causes. Ranging from simple muscle spasm to a bulging intervertebral disc to bone-on-bone compression. Treatment has to vary with the cause. Many, many AN members have has pain from compressed disks and their experiences vary widely according to the underlying cause. I have, at various times, had nerve compression in both back and hand, from muscle spasm, from bulging intervertebral disks, from compression from bone (bone spurs, collapsed inter-vertebral space) and from narrowed carpal tunnel space. All of these were treated differently according to the underlying cause: -exercise (manly stretches) and medication - hand splints - steroid injections - surgery You really need to specify where on the body this is, how severe (e.g. does the pain or numbness radiate) and, if known, the cause. Also, since you specifically state "pinched nerve", it sounds like it has been so diagnosed. Who made that diagnosis, and how? For nerve compression in the spine, Xrays and MRIs are needed for diagnosis. Xray at a minimum, and often MRI.

Please keep it civil. The discussion is about the duration of protection given by the vaccine. It is impossible to measure this beyond the time that anyone has thus far been vaccinated for. No sign of decreasing protection has been found in vaccinated individuals to date, but the vaccine has only been on market for 7-8 years and even the initial clinical trials (smaller number of people) are only 10-11 years ago. Hence you will read that protection is at least 7/8, or 10/11 years. That does not mean it is only that long. It means that this is the longest time span for which protection can currently be measured. It may well turn out to protect for 20, 30, 40 years - who knows. If, once enough time has passed to measure protection in people vaccinated more than a decade ago, it is found that at some point protection wanes then booster will be recommended accordingly.

Please give some info re your water source first. Urban or rural? City water supply or well?or rain wster? Etc

Where in Thailand are you located? If in Pattaya, Dr. Anna as above. In Bangkok, the government Institute of Dermatology. https://www.iod.go.th/home In Chiang Msi, Dr. Vachiraporn as per tbis thread https://aseannow.com/topic/1371509-dermatologist-in-chiang-mai

Gaba and the like are so far still OTC in Thailand.

This and all other benzis are ckntrolled drugs in Thaikand. Cannot be legally obtained except from a hospital or clinic. This has been the case fod many years now. These drugs are addictive and abuse potential is high.

What you describe may be the effects of your AMD. Which the injections are intended to halt the progression of, but it does take time and you have not yet completed the loading dose. As previously explained the injections will halt the progression in about 90% of patients i.e. it will stop getting worse. A smaller percentage (about one third) will see improvement compared to baseline. Again, I urge you to discuss this with your doctor. Contact the doctor NOW to report the further deckine in vision, the Dr might decide to have you come in sooner and/or change drugs.

You seem to be describing a single event but you said you got 2 Shingtix doses for that price, can you clarify? Provincial government hospitals do not usually gave Shingrix.

LDL: avoid processed carbs and processed meats. Consume only healthy oils (olive oil etc). This last means avoiding pretty much all fried foods in the market and at restaurants as they use (and reuse, which is even worse) mostly palm oil. Uric acid: same as above plus minimize red meat, avoid organ meats and shellfish, and avoid or minimize alcohol. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/gout-diet/art-20048524

The above are the details of this private practice, at BNH hospital, a private hospital. I saw him there. He will want to see an MRI, you can save money by getting it here first: www.mrithailand.com There is a branch near Silom. Bring it on CD, don't worry about the report, he'll read the scan himself. He will also want to do Xrays, that has to be at BNH as he has his own protocol for them.

That chart is not at all accurate. Abdominal hysterectomies are no more painful than any other abdominal surgery. Laoaroscopic abdominal surgeries are much less painful post op than open procedures.

This is of course a possibility and why he needs to consult a specialist in spinal problems. Unlike you, OP has had past injuries, and has documented spinal stenosis. But that does not necessarily mean that the latter (which many people have) fully accounts for his symptoms. Needs expert evaluation.

Closed per OP request.

Where in Chiang Rai did you get 2 doses for a total of 6800, and are you sure it was Shingrix and not Zostavax?

I had a lumbar fusion a year ago with excellent results. But I wad a good surgical risk, which you might not be. And the fusion was recommended and performed by the country's top spinal specialist. There were specific indications in my case for fusion as opposed to the simpler minimally invasive decompredsion surgeries which are nowadays more vommonly performed.. Your case may be different. It takes a lot of experience and expertise to know which patients will benefit from surgery and which type of surgery is best for a specific patient. i suggest you consult https://www.bnhhospital.com/search-doctor/entry/4093/ I would not delay as your symptoms are alarming (radiculopathy down to the feet).